Basic Surgical Techniques 5th ed - R. Kirk (Churchill Livingstone, 2002) WW
Paul R. Goddard, ,Diagnostic Imaging of the Chest (1987) Churchill Livingstone,New York.
1
512 CLINICAL RADIOLOGY Book Reviews Pioneers and Early Years. A History of British Radiology. By E. H. Burrows. Colophon, Alderney, 1986. 264 pp., 110 figs. £32.50. The approaching centenary of Roentgen's great achievement may have provided the stimulus for this account of the reception and development of 'A New Kind of Light' in Britain and few could have been better equipped to write it than Dr Burrows. A talent for histori- cal awareness combines with a pleasant readable style in the present work based on in-depth research often involving obscure periodicals. The result is a clear picture of the struggles and frustrations of the pioneers to establish the new science primarily in its own right but almost immediately afterwards in its application to medicine. Compared with other national histories, the present volume is no mere chronicle of events and personalities but has a narrative quality which is likely to ensure its acceptance by medical and scientific historians and by a wider readership interested in things past. The author has wisely limited his time span so that the story ends before the last war yet for one who is too young to have known at first hand the difficulties of the early apparatus or the personalities involved he displays a remarkable ability to convey the vicissitudes of the one and the vision and enthusiasms of the other. Like Herodotus he frequently digresses into local history and anecdote and the many famous quotes he has unearthed add piquancy to the narrative. Appropriately intercalated with the text are short biographies of the pioneers who by their own trials and ingenuity so materially ensured the progress of the new science. Indeed, many of the trials were of a more personal kind and full tribute is paid to those who suffered radiation trauma in the cause. It is salutary to be reminded of both the many British martyrs and of the stimulus they gave to the establish- ment of the world's first Radiation Protection Committee. Other British firsts were in the fields of societies and journals and the author has clearly shown their relationships and how the various conflicts between the scientific and medical elements were eventually resolved and harmony restored to result in the British Institute of Radiology with its present high standing. We learn how educational and certifica- tion needs prompted the foundation of appropriate bodies in radiol- ogy, radiography and hospital physics. Academic status was achieved with the establishment of the Cambridge diploma in 1919 but it took many years before radiology was accorded its due place in medicine. A. E. Barclay, who was known as 'The Grand Old Man of British Radiology' and was responsible for the diploma, fought many verbal battles with famous clinicians of his day on this issue. The story of Hall- Edwards of Birmingham is told in all its heroic tragedy; he continued to lecture after both hands had been amputated for radiation injuries and his case was the major factor in calling public attention to the price that had to be paid for the benefits of X-rays. Descriptions of the early coils, tubes and interrupters are surprisingly well illustrated by the old photographs which enable the reader to realise what formidable logistical problems were faced by those who took X-rays to war even before the turn of the century. Indeed this is one of the most enthralling chapters of the whole book as few people realise that X-rays were in use close to the battlefield in the Graeco-Turkish war in 1897. Perhaps the author can be forgiven the relative neglect of X-ray and radium treatment which was often empirical in the absence of reliable units of measurement until the work of Kaye and Sidney Russ, though he does record the use of radiation in leukaemia, goitre and malignancies by Bruce, Finzi and others in 1907. Such a well-bound, beautifully printed volume deserves a place on the shelves of all who are directly or contingently interested in the development of radiation science. Read in conjunction with R. F. Mould's pictorial 'A History of X-rays and Radium' and it will give the young radiologist of today a clear perspective of what is indeed a goodly heritage. Thomas Lodge Magnetic Resonance of the Muscuioskeletal System. Edited by T. H. Berquist with R. L. Ehman and M. L. Richardson. Raven, New York, 1986. 234 pp., 195 figs. $32.50. It has become increasingly clear that assessment of disorders of the musculoskeletal system is destined to become one of the major applications of MRI. This monograph is one of the first to draw together the knowledge base in this area and attempt an overview. An elementary account of the basic principles of MRI is followed by an excellent chapter which discusses the complexities underlying image interpretation. There is a particularly clear account of the various factors which can influence the signal intensity of vascular structures and the way they are subsequently displayed. The technical factors which have to be considered in order to obtain images of optimal quality are then addressed, but regrettably the discussion of image quality and the many variables on which it depends is too superficial to allow the reader to gain a clear understanding of how in practice an operator draws up a protocol for a given examination, The chapters on clinical applications cover those areas which have been most studied: bone and soft tissue tumours, infection and trauma with a separate section on the spine. The final chapter on miscellaneous conditions brings together a discussion of such topics as osteonecrosis and muscle disease. The references given at the end of each chapter are comprehensive and cover the published literature up to the end of 1985. Unfor- tunately, as befalls all books currently written on MRI, during the period between manuscript submission and the end product further research will have improved machine capabilities and extended and refined the clinical applications of the technique. As a consequence of this, the quality of several illustrations in this book must now be regarded as poor and the text is inevitably deficient because of the developments which have occurred in the last 18 months. Such topics as degenerative and rheumatoid disease of the cervical spine and affections of the shoulder joint must await the next edition. This book can be recommended as an introduction to this important area of application of MRI which can be built on by reading the current literature. B. Worthington Diagnostic Imaging of the Chest. By Paul R. Goddard. Churchill Livingstone, Edinburgh, 1987. The author, an experienced chest radiologist, has written this book 'to introduce the newer imaging techniques .... for examining the chest and to discuss them in the setting of diagnostic and management problems.' To this end a large number of interesting cases are used to illustrate the declared aim of each chapter. On the whole this aim is achieved but the book itself pleases and perplexes with its somewhat uneven mixture of good common sense and unfinished comment. There is often a lack of deductive reasoning in the approach to individual problems so that the reader is not guided firmly towards the preferred method of investigation with cogent explanation on the way. Why is bronchography shown in sequestration but not angiography? Why was CT carried out for tuberculosis which was apparent on the PA radiograph? Since the text is aimed at the relatively uninitiated we are not instructed sufficiently in the relative value of an investigation in a particular circumstance. The general quality of reproductions of the chest radiographs is good but sometimes not good enough; the CT scans are barely adequ- ate for a modern publication although in fairness they usually make the point under discussion so that the message 'comes across'. Perhaps publication should have been delayed until new generation CT scans became available. The style of writing is chatty, personalised and idiosyncratic but none the worse for that. Exception however is definitely taken to the use of the term 'coin lesion' which belies the third dimension of the pathological process and in particular ill becomes the radiologist who, above all, is trained to think in all possible dimensions. The use of the word 'pneumopathy' caused this reviewer much distress. The book should appeal to those who have passed the first part of the FRCR and to SHOs and registrars in chest medicine, but it requires a more disciplined approach which moves progressively to the final diagnosis in the most effective manner. Basil Strickland
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Transcript of Paul R. Goddard, ,Diagnostic Imaging of the Chest (1987) Churchill Livingstone,New York.
512 CLINICAL RADIOLOGY
Book Reviews
Pioneers and Early Years. A History of British Radiology. By E. H. Burrows. Colophon, Alderney, 1986. 264 pp., 110 figs. £32.50.
The approaching centenary of Roentgen's great achievement may have provided the stimulus for this account of the reception and development of 'A New Kind of Light' in Britain and few could have been better equipped to write it than Dr Burrows. A talent for histori- cal awareness combines with a pleasant readable style in the present work based on in-depth research often involving obscure periodicals. The result is a clear picture of the struggles and frustrations of the pioneers to establish the new science primarily in its own right but almost immediately afterwards in its application to medicine.
Compared with other national histories, the present volume is no mere chronicle of events and personalities but has a narrative quality which is likely to ensure its acceptance by medical and scientific historians and by a wider readership interested in things past.
The author has wisely limited his time span so that the story ends before the last war yet for one who is too young to have known at first hand the difficulties of the early apparatus or the personalities involved he displays a remarkable ability to convey the vicissitudes of the one and the vision and enthusiasms of the other. Like Herodotus he frequently digresses into local history and anecdote and the many famous quotes he has unearthed add piquancy to the narrative. Appropriately intercalated with the text are short biographies of the pioneers who by their own trials and ingenuity so materially ensured the progress of the new science. Indeed, many of the trials were of a more personal kind and full tribute is paid to those who suffered radiation trauma in the cause. It is salutary to be reminded of both the many British martyrs and of the stimulus they gave to the establish- ment of the world's first Radiation Protection Committee. Other British firsts were in the fields of societies and journals and the author has clearly shown their relationships and how the various conflicts between the scientific and medical elements were eventually resolved and harmony restored to result in the British Institute of Radiology with its present high standing. We learn how educational and certifica- tion needs prompted the foundation of appropriate bodies in radiol- ogy, radiography and hospital physics. Academic status was achieved with the establishment of the Cambridge diploma in 1919 but it took many years before radiology was accorded its due place in medicine. A. E. Barclay, who was known as 'The Grand Old Man of British Radiology' and was responsible for the diploma, fought many verbal battles with famous clinicians of his day on this issue. The story of Hall- Edwards of Birmingham is told in all its heroic tragedy; he continued to lecture after both hands had been amputated for radiation injuries and his case was the major factor in calling public attention to the price that had to be paid for the benefits of X-rays.
Descriptions of the early coils, tubes and interrupters are surprisingly well illustrated by the old photographs which enable the reader to realise what formidable logistical problems were faced by those who took X-rays to war even before the turn of the century. Indeed this is one of the most enthralling chapters of the whole book as few people realise that X-rays were in use close to the battlefield in the Graeco-Turkish war in 1897. Perhaps the author can be forgiven the relative neglect of X-ray and radium treatment which was often empirical in the absence of reliable units of measurement until the work of Kaye and Sidney Russ, though he does record the use of radiation in leukaemia, goitre and malignancies by Bruce, Finzi and others in 1907.
Such a well-bound, beautifully printed volume deserves a place on the shelves of all who are directly or contingently interested in the development of radiation science. Read in conjunction with R. F. Mould's pictorial 'A History of X-rays and Radium' and it will give the young radiologist of today a clear perspective of what is indeed a goodly heritage.
Thomas Lodge
Magnetic Resonance of the Muscuioskeletal System. Edited by T. H. Berquist with R. L. Ehman and M. L. Richardson. Raven, New York, 1986. 234 pp., 195 figs. $32.50.
It has become increasingly clear that assessment of disorders of the musculoskeletal system is destined to become one of the major
applications of MRI. This monograph is one of the first to draw together the knowledge base in this area and attempt an overview. An elementary account of the basic principles of MRI is followed by an excellent chapter which discusses the complexities underlying image interpretation. There is a particularly clear account of the various factors which can influence the signal intensity of vascular structures and the way they are subsequently displayed. The technical factors which have to be considered in order to obtain images of optimal quality are then addressed, but regrettably the discussion of image quality and the many variables on which it depends is too superficial to allow the reader to gain a clear understanding of how in practice an operator draws up a protocol for a given examination,
The chapters on clinical applications cover those areas which have been most studied: bone and soft tissue tumours, infection and trauma with a separate section on the spine. The final chapter on miscellaneous conditions brings together a discussion of such topics as osteonecrosis and muscle disease.
The references given at the end of each chapter are comprehensive and cover the published literature up to the end of 1985. Unfor- tunately, as befalls all books currently written on MRI, during the period between manuscript submission and the end product further research will have improved machine capabilities and extended and refined the clinical applications of the technique. As a consequence of this, the quality of several illustrations in this book must now be regarded as poor and the text is inevitably deficient because of the developments which have occurred in the last 18 months. Such topics as degenerative and rheumatoid disease of the cervical spine and affections of the shoulder joint must await the next edition.
This book can be recommended as an introduction to this important area of application of MRI which can be built on by reading the current literature.
B. Worthington
Diagnostic Imaging of the Chest. By Paul R. Goddard. Churchill Livingstone, Edinburgh, 1987.
The author, an experienced chest radiologist, has written this book 'to introduce the newer imaging techniques . . . . for examining the chest and to discuss them in the setting of diagnostic and management problems.' To this end a large number of interesting cases are used to illustrate the declared aim of each chapter. On the whole this aim is achieved but the book itself pleases and perplexes with its somewhat uneven mixture of good common sense and unfinished comment. There is often a lack of deductive reasoning in the approach to individual problems so that the reader is not guided firmly towards the preferred method of investigation with cogent explanation on the way. Why is bronchography shown in sequestration but not angiography? Why was CT carried out for tuberculosis which was apparent on the PA radiograph? Since the text is aimed at the relatively uninitiated we are not instructed sufficiently in the relative value of an investigation in a particular circumstance.
The general quality of reproductions of the chest radiographs is good but sometimes not good enough; the CT scans are barely adequ- ate for a modern publication although in fairness they usually make the point under discussion so that the message 'comes across'. Perhaps publication should have been delayed until new generation CT scans became available.
The style of writing is chatty, personalised and idiosyncratic but none the worse for that. Exception however is definitely taken to the use of the term 'coin lesion' which belies the third dimension of the pathological process and in particular ill becomes the radiologist who, above all, is trained to think in all possible dimensions. The use of the word 'pneumopathy' caused this reviewer much distress.
The book should appeal to those who have passed the first part of the FRCR and to SHOs and registrars in chest medicine, but it requires a more disciplined approach which moves progressively to the final diagnosis in the most effective manner.
Basil Strickland
