412 C L I N I C A L R A D I O L O G Y

Radiology of Bone Disease, by GEORGE B. GREENFIELD. J. B. Lippincott Company, Philadelphia and Toron to - - Blackwell Scientific Publications Oxford and Edinburgh. Price £17-00.

We are told on the dust cover of this volume that "this fully illustrated new book brings a fresh analytical approach to the difficult area of bone lesion diagnosis. Its aim is to achieve a ' total information profile' based on a logical multidisciplinary technique." This jargon merely means that bone lesions are grouped by predominant radiological features rather than by aetiology, and that cognizance is taken of clinical and laboratory findings. This method had been previously used by others, notably by George Simon in Britain. The pattern must be tempting in these days of com- puter analysis. The question arises, however, whether bone conditions really lend themselves to this particular arrange- ment. My opinion is that such a classification in bone disease is much less acceptable than it is in chest diseases. One simple example will perhaps emphasize the difficulty: osteomalacia is described on page 15 amongst diseases characterized by loss of bone density whereas rickets is found on page 120 amongst lesions manifested by changes at the metaphysis. In fairness, I do suggest that personal taste must have a strong bearing on one's liking of the method so I strongly recommend that readers make up their own minds about the presentation.

The author has worked out very comprehensive lists of causes of practically everything that can happen to a bone. Candidates for higher examinations will benefit from checking their knowledge against these lists. The information is generally correct but inclined to be over-dogmatic, e.g., p. 19 - - pseudo-fractures are present in the following diseases - - should read pseudo-fractures may be present in the fol- lowing diseases; 'Scheurmann's disease - - is painful' (p. 85) - - that this disease may cause pain is not denied, but usually it does not.

The book is lavishly illustrated. Most illustrations are adequate, but some are poor, e.g., Fig. 2-39 Fig. 3-43, Fig. 3-63, Fig. 3-109, and others. Fig. 4-41 is upside down.

At £17 is unlikely that many radiologists will buy a personal copy of this book. Nevertheless, it should be noted that the volume contains a lot of material that is difficult to find elsewhere. Rarer diseases are extremely well covered and an extensive list of references is provided. For these reasons I strongly recommend purchase of the book for all radiolo- gical libraries. I t is possible, also, that others may find Dr. Greenfield's classifications more palatable than did your reviewer.

PHILIP JACOBS

Indications and Alternatives in X-Ray Diagnosis. By M. H. SCHREIBER. Charles C. Thomas, Springfield, Illinois, U.S.A. Pp. 117 + ix. Paperback. £2.05.

This small but well written volume is intended as an introduction to radiological investigation for medical students and housemen but may well be read with considerable profit by general practitioners who refer patients for exami- nation. It is not intended as a shortened text book but as a guide to the possibilities offered by radiodiagnosis in order to select the most appropriate examination. The conference and combined consultation will continue to be the best method for indicating the appropriate investigation where doubt arises, but this book fulfils a very important need in that

i t covers both conventional and newer techniques, briefly mentioning what this entails for the patient and the expected information that may be obtained.

There are no illustrations and the actual radiological signs are not considered in any detail, nevertheless the various aspects of each system are dealt with in such a way as to draw adequate guide lines for the beginner. As an example, the distinguishing features between carcinoma of prostate and Paget's disease in the bony pelvis are clearly indicated.

The cardiovascular and genito-urinary systems are par- ticularly well done with an appropriate up-to-date emphasis. High dose urography, its value in renal failure, avoidance of dehydration in patients with proteinuria, myeloma and raised blood urea, and the fact that there is no real evidence to show that modern contrast agents are dangerous in renal failure, are specifically mentioned.

It is quite natural that in a book such as this, personal opinions and preferences will be found. The author con- siders that at present the double contrast enema is overrated and that the real emphasis should be on thorough preparation with complete colonic cleansing. He unfortunately does not mention the value of the ' instant ' enema in ulcerative colitis, which certainly in this country, has become a standard procedure.

As previously mentioned, this book is intended for medical students, housemen and general practitioners and will also be found extremely helpful by radiographers, physiotherapists and laboratory technicians. As such, it is highly recommended and should prove to be a valuable addition to radiological literature.

L. KREEL

Medical X-Ray Technique. By PROF. DR. G. J. VAN DER PLAATS. 3rd Edition. Phillips Technical Library. XIV + 587 pages, 222 illustrations and 16 plates. Price £5.

This is a readable and interesting book describing in very simple terms the main points of every aspect of Radiography. It would be useful as a reference book, especially for nurses or other non-radiographic staff attached to the X-ray Department, as the book is so easy to understand.

As the book is covering such a wide range of subjects connected with radiography, it is a pity to include radio- therapy in the same book as this is a subject more or less divorced from radiography in many countries.

Some whole chapters give a very good general idea for radiography students on the introductory course, e.g. Chapter I: physical concepts, and Chapter XIV: radiographic technique, but there is very rarely enough detail for the M.S.R. students. In contrast, other chapters are far too advanced for those not already versed in elementary radio- graphy as they assume a good knowledge of basic physics.

The diagrams are very small. Radiographs are reproduced as positive, instead of negatives, which may be confusing for the new student.

The chapter on photography gives a quick, concise run- down on the whole photographic process and the equipment is clearly described and explained.

This is a book which touches on everything briefly and when used in conjunction with other more detailed text- books, would be a very useful addition to an X-ray depart- ment library.

ANN POLLARD, M.S.R. JENNIFER RICHMOND, M.S.R.