Current Orthopaedics (1998) 12, 58-59
© 1998Harcourt Brace & Co. Ltd
Book reviews
Movement, Stability and Low Back Pain. The essen-
tial role of the pelvis. Editors: Andry Vlemming, Vert
Mooney, Chris Snijders, Thomas Dorman, Rob
Stoeckart. Churchill Livingstone
ISBN 0443055742 612 pages Est. Price £60.00
Since the publication of the paper on the rupture of
the intervertebral disc in the 1930s by Mixter and
Barr, the source for low back pain has been sought in
and around the lumbar spine. Still in most cases no
clear cut explanation can be given to the patient for
his pain. The objective with this book is to highlight
the role of the pelvis and especially the sacroiliac joint
as a generator for low back pain. Sixty-eight authors
representing different medical professions, old clini-
cians as well as young researchers, have contributed to
the book. They are detailed at the beginning of the
book. The chapters are often based on the authors
own research, often published in recent years.
The book is divided into a basic research and a
clinical section. New ideas on biomechanics and
pathogenesis are introduced. Techniques for clinical
examination, imaging, conservative and surgical
treatments are presented. One section deals with preg-
nancy and low back pain. A free format and different
chapters covering almost the same subject have
resulted in some of the information being repeated.
This is not a textbook with a systematic coverage
of the subject and would not be recommended read-
ing for exams. Probably it is the most comprehensive
book on the role of the pelvis in low back pain, pre-
senting the reader with a new hypothesis about low
back pain, how it can be diagnosed and treated by
world authorities in the field. The book can be recom-
mended to anyone working with patients with low
back pain.
H. JOHNSSON
Clinical Orthopaedic Examination. Ronald McRae.
Churchill Livingstone, 1997
ISBN 044306021 302 pages Price £21.00
Now in its fourth edition, this inexpensive book will
doubtless continue to attract its target audience of
medical students, Orthopaedic (and A & E) trainees
and physiotherapists. The strip cartoon format with
58
explanatory notes gives a clear idea of the examina-
tion procedure being taught. As the author has
provided his own artwork, the illustrations are ele-
mentary but uncorrupted by artistic license. It is true
that the best way to learn a skill such as clinical exam-
ination is not from a textbook, and for pivot shift
tests and the like this is definitely true, but there is no
other readily accessible, simple guide to the array of
tests essential to the assessment of the musculoskele-
tal system.
Unfortunately there is no discussion of the value
of any of the tests in terms of sensitivity and speci-
ficity where this is known. If one were to use the book
as a problem-solving tool for a clinical case there is
inadequate description of which tests are appropriate
for which clinical presentation and which tests should
be grouped together in order to detect associated con-
ditions. I can only assume that a personal medicolegal
interest has lead the author to present his readership
with the Taylor-Palmear scale for vibration syn-
dromes of the hand before mentioning injuries, infec-
tions, arthritis and tumours.
Overall, this is an excellent introduction to the
examination of the musculoskeletal system for medi-
cal students, student physiotherapists and SilOs pur-
suing a career in A&E medicine or Orthopaedics. It
has less to offer the Specialist Registrar in
Orthopaedics, coverage of more advanced and
dynamic tests being inadequate in many areas.
D. LIMB
The Foot, 2nd edn
By Ian J Alexander
Churchill Livingstone, 1997
ISBN 0443076561 195 pages Price £25.00
This is a super little book. It is aimed at those interested
in developing their clinical skills as providers of foot
and ankle care. In this it meets its objectives admirably.
The text is succinct and makes easy reading. It is
both generously and appropriately illustrated with
black and white line drawings. Much has been
achieved in so compact a volume.
It is, however, almost exclusively diagnostic and
thus has great value but it does not deal with the man-
agement of the condition which it describes. As far as
the orthopaedic trainee is concerned this is its main
disadvantage. Nevertheless, it is still worth a read as
there are diagnostic pearls which would usefully