RHEUMATOID ARTHRITIS. Authors: J. D. Isaacs and L. W. Moreland. £12.00. Health Press Limited, Oxford, UK, 2002. 96 pages. ISBN 1-903734-16-9

J. Silberbauer and A. Leak

Fast Facts: Rheumatoid Arthritis is designed to appeal to the non-specialist physician and rheumatologist in training wanting an up-to-date text on this important disease.

Topics covered provide a comprehensive yet concise approach to understanding the disease process and its modern management. Although generally directed at those involved in secondary care, primary health care professionals will also find this an informative and useful read. One of the reviewers is a senior house officer in rheumatology training for membership of the Royal College of Physicians.

The 10 chapters are easy to read and well set out. They include highlighted areas on key points and up-to-date references for further reading. Colour figures and illustrations and tables enhance the reader's understanding of the more complex issues covered. Other illustrations include microscopy, arthroscopy, clinical signs and radiological investigations.

The authors begin with the normal anatomy and structure of joint tissues. Models of rheumatoid arthritis (RA) aetiology and pathogenesis with emphasis on genetic, immunological and environmental factors are broadly discussed, giving the reader a feel for the heterogeneity of RA. With a global prevalence of 1%, the socio-economic effects of RA are highlighted. RA has a wide variety of articular and extra-articular manifestations. These clinical features are clearly presented along with diagnostic and severity assessment criteria. Current methods of investigation for diagnosis and monitoring along with possible avenues for the future are elaborated. Although the multidisciplinary approach to RA management is not expanded on, the roles of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, early use of disease-modifying anti-rheumatic drugs (DMARDs) and surgery are clearly explained and reflect current best practice. The authors finish with current and future biological response modifiers, for example tumour necrosis factor-{alpha} and interleukin-1 inhibitors that are set to revolutionize RA treatment. There is no doubt this is an extremely useful text for its intended audience.





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