Advanced Examination Techniques in Orthopaedics

Reviews / Votes

The increasing use of high quality diagnostic imaging techniques in musculoskeletal medicine is an enormous advance in our ability to diagnose and advise patients. The reliance on diagnostic testing must be balanced by improved history taking and clinical assessment - not only to interpret the results of any diagnostic testing, but also to direct appropriate use of these expensive and scarce modalities. The mantra - when in doubt, examine the patient has never been truer than at this time. Advanced Examination Techniques in Orthopaedics is a very good attempt to improve our clinical skills in musculoskeletal patients. The book is clearly laid out in an anatomical basis with beneficial overlap between different sections. It uses bullet points, information tables, summary boxes and clear photographs to present information clearly and to highlight important hints and common pitfalls. Particular clinical tests are explained and shown clearly. The authors are to be congratulated for the indexing of the individual eponymous clinical tests, as this will be very useful for quick revision work. The editorial decision to use attractive models for the purpose of the clinical examination is pleasing to the eye, but in some examples it would have been less distracting if the photograph dealt with the anatomy under direct clinical examination - rather than alluring profiles of the model concerned. However, it does give the book a certain "don't put down quality". This book will be very valuable for trainee and practising Orthopaedic Surgeons in their day-to-day work. It is an absolute must for trainees about to sit higher specialist examinations. Rheumatologists, sports physicians and GP's with an interest in Orthopaedics Medicine will also find this book very valuable. This book is well laid out in hardback. In the preface, the author notes that he found it difficult to revise specialist tests on clinical examination quickly when preparing for the FRCS in orthopaedics and trauma. In particular, it was difficult to find these in general textbooks as they were mainly confined to specialist textbooks. He aimed to produce a comprehensive, easy reference guide for these examination techniques, which he has successfully achieved. This is an up-to-date review of modern examination techniques and should be the standard textbook for specialist registrars sitting the exit examination in trauma and orthopaedic surgery. Candidates are often worried about examination techniques. This text is comprehensive and, if read and practised correctly, should be the basis of confidently mastering the clinical section of the examination. It is vital that specialist registrars read and learn the appropriate examination techniques at an early stage; not only for the intercollegiate examination, but also for those in year 1 onwards it should be an integral part of the training at the beginning of their specialist careers. Sections that are particularly useful are those on the knee, shoulder and wrist. Older textbooks are out-of-date on certain aspects of examination techniques, such as postero-lateral instability of the knee, the Kirk-Watson test of the wrist and certain rotator cuff abnormalities. This book covers these areas well and succinctly. Apart from assessment of joints, the book also covers neurological examinations well, including brachial plexus and peripheral nerve injuries. The section on children's orthopaedic examination is well referenced, if rather brief. However, it would probably be outside the remit of the book to elaborate further on this topic. All the sections are well referenced with relevant papers that are up-to-date. The writing style is easy to read and the colour photographs and illustrations are clear. Although there Examination of the musculoskeletal system is an important part of many clinicians' daily practice. The aim of this book is to bring together the advanced techniques of examination of the components of the musculoskeletal system and it achieves this. The target audience is postgraduates undertaking examinations in orthopaedics but it has a wider appeal and should be read by all involved in postgraduate and undergraduate teaching, physiotherapists and rheumatologists, and specialist general practitioners. It is a book that will appeal visually to most orthopaedic specialists. The many colour illustrations demonstrate normal anatomy. Certain physical signs are best demonstrated with examples and there is a paucity of positive examples except in the chapters relating to children's conditions. Overlap between different authors is generally avoided but not altogether. The grading of muscle power is given in examination of the hand and examination of the brachial plexus, it is almost identical in both tables, but attributed to different sources, which could confuse exam candidates. Certain parts of the body are more amenable to comprehensive cover, and are well done, such as that of examination of the shoulder. The overall style is of necessity didactic. Areas of contention or controversy are hinted at in the chapter on examination of the spine but not expanded upon. This is a book I would recommend as a useful addition to all postgraduate libraries and it should be on the reading list of all postgraduates taking examinations involving the musculoskeletal system.