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Oxford Textbook of Musculoskeletal Medicine (2nd Edition)

Article  in  The Journal of Rheumatology · June 2016

DOI: 10.3899/jrheum.160251

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The Journal of Rheumatology Volume 43, no. 6

Oxford Textbook of Musculoskeletal Medicine (2nd Edition)

PHILIP A. BAER

J Rheumatol 2016;43;1262
http://www.jrheum.org/content/43/6/1262

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The Journal of Rheumatology is a monthly international serial edited by Earl D.

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Oxford Textbook of Musculoskeletal Medicine (2nd Edition)
Michael Hutson and Adam Ward, eds. Oxford: Oxford University Press,
2016, 768 pages, $325 US
What is musculoskeletal (MSK) medicine? It certainly is not rheumatology,
though rheumatologists with an open mind to diseases outside the familiar
realm of inflammatory arthritides and connective tissue diseases could
certainly benefit from increasing their knowledge of this field. Two rheuma-
tologists contributed to this updated multiauthored textbook Oxford Textbook
of Musculoskeletal Medicine, first published in 2005. Most authors are
British, with many others from Europe and other Commonwealth countries,
and a few from the United States. Physiatrists, physiotherapists, osteopaths,
sports medicine specialists, and orthopedists are best represented among
chapter authors. Many authors’ field of expertise is not stated, a significant
omission.
Early chapters cover foundational aspects and controversies in the field
of manual/MSK medicine. The concept of somatic dysfunction is introduced
as a better explanation for syndromes such as nonspecific back pain than
structural pathology, which we know correlates poorly with symptoms and
disability. Biopsychosocial models of pain are extensively discussed. The
wise use of the term “fibromyalgia” is sensitively reviewed. The idea that
myofascial pain syndrome is a bogus construct was interesting, and certainly
Personal non-commercial use only. The Journal of Rheumatology Copyright © 2016. All rights reserved.
1262
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substantiated my impressions regarding the lack of proven efficacy of trigger
point injections. I also learned about tensegrity, a term coined by
Buckminster Fuller, and its applicability to human biomechanics.
The bulk of the textbook covers the assessment of regional MSK
disorders, with excellent illustrations of various diagnostic maneuvers,
particularly regarding the shoulder and the sacroiliac joints. The concluding
section on management strategies includes interesting segments on patient
education, manual medicine, and exercise therapy. Other therapies, including
prolotherapy, epidural, and spinal injections will be somewhat foreign to the
practice of most mainstream rheumatologists.
I would recommend this textbook to seasoned rheumatologists with an
interest in orthopedic medicine and regional MSK syndromes. Physiatrists,
physiotherapists, chiropractors, and sports medicine specialists will also find
the material intriguing.
PHILIP A. BAER, MDCM, FRCPC, FACR, Chair, Section on Rheumatology,
Ontario Medical Association, Toronto, and Editor-in-chief, Journal of the
Canadian Rheumatology Association, Newmarket, Ontario, Canada.
Address correspondence to Dr. P.A. Baer, 305-1333 Neilson Road,
Scarborough, Ontario M1B4Y9, Canada. E-mail: Philip.baer@rogers.com
J Rheumatol 2016;43:6; doi:10.3899/jrheum.160251
The Journal of Rheumatology 2016; 43:6