260 CLINICAL RADIOLOGY

BOOK REVIEWS

A System of Orthopaedics and Fractures. By A. Graham Apley. Fourth Edition. Butterworth, London. 540 pp. 1841 illus. £8.80.

Previous editions of this book on Orthopaedics and Frac- tures have gained superlative reviews. Nevertheless, the author has rigorously pruned his material for this fourth edition and has included important recent advances. That the book is no larger is, in itself, a tremendous achievement because authors are understandably reluctant to 'murder their darlings'.

The text is informative, clear, concise and a pleasure to read. The illustrations are outstanding. In all, 1,841 pictures are arranged in composite form to demonstrate the clinical, radiological and therapeutic aspects of some 347 conditions. Usually tiny illustrations of radiographs are not much use. The author 's prints, however, are exceptional; skilful cropping, good radiographs of gross abnormalities, and high quality paper all contribute to their success. The publishers have certainly done full justice to the author 's material and produced a book of the highest standards.

Mr. Apley is clearly a gifted teacher and I found his book to be compelling reading. For that reason, a few criticisms are offered that are no more than minor. Why does the author call the capitate bone the 'os magnum' - a term that should have been discarded at least 40 years ago? Descriptions of some terms are a little woolly, e.g. 'osteolysis is the term used when bone disappears for no obvious reason', p.5. On p.83, in consecutive paragraphs on Paget's disease the terms resorption and absorption are used. I believe that they mean the same thing and that the word 'resorption' should be eschewed. On p.93, the author includes rickets as a cause of osteoporosis - this is clearly a contradiction in concept. Mr. Apley may have to scrap his aphorism 'dead bone is dense bone' when recent research findings become established fact. I note that on at least two occasions the word 'providing' is used where 'provided' would be correct.

Radiological trainees and radiologists need a desk-side book on Orthopaedics and Fractures. This is undeniably the one to buy. Mr. Apley makes two elementary points that one

wishes at times were better appreciated in routine work. First, portable films are inadequate in the investigation of spinal injuries. Second, flexion and extension films may be invaluable in the study of neck injuries, but the head should be moved by the doctor himself (my italics). The book was written for F.R.C.S. candidates, but so clear is the text that it is also eminently suitable for medical students. When one considers that bo th Orthopaedics and Fractures are covered, the price of £8.80 represents one of the best buys of any medical book available today.

PHILIP JACOBS

Clinical Radiology in the Lymphomas. By HENRY NGAN and K~IT~ W. JAMES. Published by Butterworths. (Radiology in Clinical Diagnosis Series.)

A diagnostic radiologist and radiotherapist have combined to produce a worthwhile little book on the radiology of the lymphomas. The text is clear and the illustrations make their point. The book is directed at clinicians and radio- logists in training and its appearance is timely because so much has been done for Hodgkin's Disease over the last ten years, and it now seems likely that much more may be possible for the non-Hodgkin lymphomas.

Progress results from people of different disciplines understanding each other and combining to resolve the patient's problems. This up to date text will help the clinician to realise what the radiologist can achieve and what his limitations are, and will help to give the radiologist the background which enables him to produce relevant initial information for staging and then for monitoring the progress of these diseases.

The authors give a lot of interesting information in a small space, for example the section on opportunistic infections is important because it is easy to miss these if one is not aware of their possible occurrence.

J. S. MACDONALD