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Diagnostic Imaging: Orthopaedics

Philadelphia, Pa: Elsevier, 2004. ISBN 0-7216-2920-2. Hardcover, $249.00; pp 992; 4400 illustrations.

The purpose of this text is to address the growing importance of magnetic resonance (MR) imaging in orthopedics and sports medicine. The intended audience includes radiologists, orthopedic surgeons, and sports medicine physicians. The text was written by well-known musculoskeletal radiologists, including David Stoller, who has previously published several major texts on musculoskeletal MR imaging. Diagnostic Imaging: Orthopaedics is a well-organized, well-written, superbly illustrated, and informative text that is sure to become a permanent resource at the workstation of any radiologist who interprets musculoskeletal MR images.

The book is extremely well organized. There are nine chapters. Six chapters are dedicated to the joints of the appendicular skeleton, and the remaining three chapters discuss bone marrow, bone tumors, and soft-tissue tumors. The spine and temporomandibular joint are not covered. Each chapter is divided by subheadings. For example, the knee chapter contains subheadings on the menisci; the anterior cruciate ligament; the posterior cruciate ligament; the medial collateral ligament; the lateral collateral ligament complex; osseous and cartilaginous structures; the extensor mechanism; arthritis, synovitis, and bursitis; and synovial and degenerative cysts. Several conditions are discussed beneath each subheading. For example, the conditions that are covered under the meniscus subheading include discoid meniscus, meniscal cysts, meniscocapsular separation, meniscal bucket-handle tear, and meniscal radial tear.

Each condition is covered on four pages, which are further divided into sections that present terminology (definitions, abbreviations, and synonyms), imaging findings (MR imaging, computed tomography [CT], conventional radiography, ultrasonography (US), and nuclear medicine), differential diagnosis (including thumbnail images of differential diagnoses), pathologic findings, clinical issues, a diagnostic checklist of associated findings and "pearls," and an image gallery that contains four to six examples of each condition. Each condition is accompanied by at least one high-quality color illustration to demonstrate the relevant anatomic and pathologic characteristics. In addition, a color-coded "key facts" summary is provided at the top of the second page for quick reference. This effective four-page layout is repeated in the same order throughout the book for every condition discussed.

The text is in outline format rather than in prose format. This enables readers to rapidly scan the facts and find the particular information they are looking for. Large amounts of information are condensed into brief, bulleted text. For each condition, information is provided on the appearance at MR imaging; additional information may be presented on the appearance at conventional radiography, CT, US, and/or bone scanning, if relevant. Also provided are demographics, causes, pathologic characteristics, staging, natural history and progression, treatment, and brief descriptions of the major differential diagnoses. While anyone who needs a large amount of information about a certain condition will need to use a more in-depth text, this text will give the reader a concise but thorough overview.

While there are a few conventional radiographs, nuclear medicine images, and CT scans (as well as some gross specimen and arthroscopic images), the majority of the images are MR images. This focus on MR imaging reflects the ever-increasing importance of this modality in the interpretation of musculoskeletal conditions. This 992-page text contains more than 1000 radiologic images and more than 550 color illustrations. The images are top quality, and the illustrations by Salvador Beltran are excellent.

The consistent format, outline form, bulleted text, and large number of top-quality images and illustrations make for exceptionally quick and easy reference. This book is an invaluable resource for anyone who interprets musculoskeletal MR images—from the senior resident or fellow who has an interest in musculoskeletal imaging, to the general radiologist who interprets musculoskeletal images, to the dedicated musculoskeletal radiologist. The cost of the text ($249) is reasonable, especially given the enormous amount of information covered and the thousands of images presented.

Reviewed by Claire A. Coggins, MD

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