OXFORD TEXTBOOK OF RHEUMATOLOGY. Edited by A. Hakim and G. P. R. Clunie. £19.95. Oxford University Press, Oxford, 2002. 561 pages. ISBN 0-9-263054-7

Y. Ioannou

This book, written by two fairly recently appointed consultants in rheumatology, provides a useful introduction to rheumatology and seems squarely aimed at the training rheumatologist and the general practitioner with an interest in musculoskeletal disorders. Editorial advice is provided by the editors of its successful big brother—Oxford textbook of rheumatology, which is now in its second edition. However, it would be inaccurate to describe this handbook as a mini reference textbook. Rather, it goes a step further by representing a useful guide to aid readers to arrive at an appropriate differential diagnosis given specific musculoskeletal presentations.

This is essentially a book of two halves (please excuse the reference to football but at the time of writing this review the World Cup was on!). The first half (Part 1) kicks off with an introduction to evaluating musculoskeletal pain with a useful small section on assessment of pain in young children. The next two sections are devoted to explaining how to come to a working diagnosis given a specific regional musculoskeletal symptom or given a specific pattern of disease. Hence there are chapters on shoulder pain, lower leg and foot disorders, low back pain, oligoarticular arthritis and widespread pain. Where relevant, chapters dedicated to children and adolescents are also included, such as spinal disorders, widespread pain and oligoarticular pain to name but a few. The first half culminates with a chapter on how rheumatic presentations can arise from non-autoimmune rheumatic processes, with sections on endocrine conditions and malignancy, for example. The second half, however, follows a more conventional strategy. In essence, clinical features and management of common (and even not so common) rheumatic diseases are covered distilling essential and up-to-date, evidence-based information into concise chapters ranging from rheumatoid arthritis to fibromyalgia. Pictures are included as good quality coloured plates and where appropriate there are tables and flow diagrams to summarize salient information. The fact that rheumatology continues to evolve rapidly with more exciting new therapies on the horizon may mean that new editions will be required in the not too distant future if it is to remain up to date. A chapter on sport-related injuries or even eponymous rheumatological syndromes would have been a welcome sight, but I suspect space was a limiting factor. Senior house officers, general practitioners and probably some year 1 rheumatology SpRs will find the section on regional corticosteroid injection therapy useful, which is backed up by colour plates.

So who would most benefit from reading this book? Well this is invaluable to anyone who is new to the specialty, or who sees occasional rheumatic problems and needs to identify serious from benign pathology, for example. It is essentially the first concise but readable text outlining how to evaluate commonly presenting rheumatic complaints that I have come across, which as a trainee I found practically very useful. Hence I unreservedly recommend this book to general practitioners, certainly junior doctors training in rheumatology and indeed any physician with an active interest in the speciality.





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