Exercises in Radiological Diagnosis

usually require more guidance in interpreting the data they receive than in selecting the investigations their patients require. The omission from some of the chapters of adequate information about normal ranges, not to mention the absence of a discussion of which data are normally distributed and which are not, must limit the book's general appeal. All clinicians will be pleased to find that the necessity of interpreting electrophysiological findings in the clinical context is properly stressed throughout. Whilst clinical neurophysiology is likely to continue to complement modern imaging techniques for some time to come it is clear that its ultimate contribution to clinical management will probably emphasize the functional as opposed to the structural abnormalities which it can demonstrate. These portents are well discussed in relation to computerisation of EEG and evoked potentials, and all too briefly in chapters dealing with central nervous system disorders and event related potentials. For the clinical neurophysiologist, often practising in relative isolation, there is an abundance of thoughtprovoking information and probably some invaluable refresher material as well. There are a few surprises, such as the definition of supramaximal stimulation. The statement that somatosensory evoked potentials give a higher yield than visual evoked potentials in the diagnosis of multiple sclerosis surely requires some qualification. There may also be a few UK readers unaware that evoked potential recording in theatre costs 700 dollars per case. This is an excellent book, beautifully produced, and no department of clinical neurophysiology should be without one.

usually require more guidance in interpreting the data they receive than in selecting the investigations their patients require. The omission from some of the chapters of adequate information about normal ranges, not to mention the absence of a discussion of which data are normally distributed and which are not, must limit the book's general appeal. All clinicians will be pleased to find that the necessity of interpreting electrophysiological findings in the clinical context is properly stressed throughout.
Whilst clinical neurophysiology is likely to continue to complement modern imaging techniques for some time to come it is clear that its ultimate contribution to clinical management will probably emphasize the functional as opposed to the structural abnormalities which it can demonstrate. These portents are well discussed in relation to computerisation of EEG and evoked potentials, and all too briefly in chapters dealing with central nervous system disorders and event related potentials.
For the clinical neurophysiologist, often practising in relative isolation, there is an abundance of thoughtprovoking information and probably some invaluable refresher material as well.
There are a few surprises, such as the definition of supramaximal stimulation. The statement that somatosensory evoked potentials give a higher yield than visual evoked potentials in the diagnosis of multiple sclerosis surely requires some qualification. There may also be a few UK readers unaware that evoked potential recording in theatre costs 700 dollars per case. This is an excellent book, beautifully produced, and no department of clinical neurophysiology should be without one.
From sixth form days, I recall very vividly the acute hypertension produced in the senior chemistry master by the sight of the whole of the front row of the class ostentatiously displaying copies of Teach Yourself Chemistry in their bright yellow covers during the headmaster's visit to the class. With this in mind it may not be apt for a radiologist to be reviewing the present volume, since it is, in effect, a physician's Teach Yourself Radiology.
The meat of this slim paperback consists of 68 figures, each with a brief clinical history and one or more questions about its interpretation. The vast majority of the illustrations are of plain films of the chest, abdomen or bones, with a few bariums (single contrast only), IVUs and CT scans, and one or two ultrasound scans. The exercises are arranged in no particular order, the answers being grouped together at the end of the book. Most of the answers discuss the radiological findings, differential diagnosis, and further management, and in some cases they are illustrated by additional procedures. The authors are a radiologist and a professor of medicine.
The effect of reading through the book is similar to that of spending a couple of hours in a well stocked and well documented film library. The book has the advantage that it fits easily into a coat pocket, but also the disadvantages of severe limitations in the range and number of cases shown, and the inevitable loss of image quality involved in bringing transparencies to the printed page. In particular, some of the detailed features described on the chest and bone radiographs were not convincingly perceptible in my copy of the book, and a few of the illustrations are reproduced at a size which is uncomfortably small. Although a few contentious points of interpretation and management have crept into the text, the authors have very largely avoided controversy.
The book is aimed at medical students, general practitioners and postgraduates in the core specialties and is based on the authors' premise that '. . . most clinicians are expected to be able to interpret their own radiographs'. Whilst I would give guarded support to this aim, I do find it difficult to accept the publishers claim that '. . careful study of [this book] will provide a working knowledge of a radiological interpretation .', an allegation which might have difficulty with the Advertising Standards Authority.
In summary, this is a brave attempt to provide a miniature film library for beginners in the field of radiologic interpretation. I am happy to recommend it on the principle that a little knowledge is less dangerous than no knowledge at all. Sir Norman Jeffcoate wrote the first edition of his Principles of Gynaecology thirty years ago in 1957 and his last (4th) Edition appeared over ten years ago in 1974. During these years it became the standard textbook of gynaecology for most undergraduates and postgraduates in the English-speaking world. Professor Victor Tindall has taken on the job of revising for today's students this famous textbookwhat a daunting task! The popularity of Jeffcoate's Principles of Gynaecology was based on its style, never a turgid recitation of facts, but rather a very personal description with many views which are nothing if not dogmatic. He admits himself, in one of his prefaces, that he enunciates ideas which are often conjectural, but which are there to provoke thoughts and discussion. Professor Tindall has retained the lay-out and most of the contents of the last Edition and thus the essential flavour of the book is unchanged.