602 CLINICAL RADIOLOGY

Book Review Computed Tomography of the Musculoskeletal System. Edited by

William W. Scott Jr, Donna Magid and Elliott K. Fishman. Churchill Livingstone, Edinburgh and New York, 1987. 269 pp. £32.50.

This volume is number 8 in a series entitled 'Contemporary Issues in Computed Tomography' . It is important to note that spinal com- puted tomography (CT) is not included and is covered in Volume 2.

The book is produced by a series of contributors under the combined editorship of three radiologists based in the Johns Hopkins Medical Institutions in Baltimore. It comprises 10 chapters, the first eight relate to computed tomography under subject or regional headings such as soft tissue masses, primary bone tumours, the foot or the shoulder. The ninth chapter discusses nuclear magnetic resonance imaging and the tenth, and final chapter outlines advances in CT imaging of musculoskeletal pathology, in particular three dimensional reconstruction and metal suppression programmes.

The book is generally helpful, well produced and illustrated, but suffers from being purely technique orientated. There is little attempt to place CT in the logical investigational sequence. Conse- quently few plain films, scintigrams, ultrasound or other examina- tions are included. A noticeable example appears in the section dealing with stress lesions of bone where the authors illustrate subtle

features to diagnose stress fractures on CT without illustrating the much simpler and cost effective radionuclide bone scan.

The nuclear magnetic resonance chapter is helpful but a grey scale illustration (Figure 9-2) has been borrowed (with due acknowledg- ment) from another source. This illustrates the 'blackness' or 'whiteness' of such tissues as liver, hepatoma and breast carcinoma which I feel are not greatly relevant to the average musculo-skeletal radiologist.

The book itself concludes with five illustrative cases. These are assumed to represent a teaching exercise, but the logic of their selection is not easy to appreciate. Again they illustrate clearly the dependency on technique orientated radiology. One final comment, one cannot help but note that in all there are some 360 cited references to the literature. Only 26 are from non-American sources (10 of these relate to the single chapter on nuclear magnetic resonance). Many valuable articles appeared, of course, in the European literature and it is a pity to see them excluded once again from an American textbook.

This book is undoubtedly a useful addition to the libraries of any teaching department of radiology or orthopaedic surgery. For British practice it will need to be coupled with the volume relating to the spine. Departments of radiology specialising in musculo- skeletal disease will almost certainly have their copies but I doubt that individuals will find their meagre funds stretching to encompass its purchase. Iain Watt