Imaging of Orthopaedic Fixation Devices and Prostheses. Thomas Berquist, M.D. (Author). Wolters Kluwer | Lippincott Williams & Wilkins, 2008, 736 pages, 1953 illustrations, $210.00.
Orthopedic hardware has always been a bit of a stumbling block for the practicing radiologist. When it comes to dictating post fixation films, most of us find ourselves mumbling something we hope is sufficiently innocuous to keep us from looking, well, foolish. The resultant vague reports are not of much use to the orthopedic surgeon and they are a potential disservice to the patient. Furthermore, dissatisfied referring orthopedic surgeons frustrated by useless and potentially misleading reports may respond by reading their own radiographs, pocketing the professional fee and cutting the radiologist out of the pattern altogether. It is incumbent upon radiologists therefore to educate themselves to produce informative and meaningful radiographic reports in postoperative patients with orthopedic hardware in place. A new textbook from entitled Imaging of Orthopaedic Fixation Devices and Prostheses may help practicing radiologists do just that.
Imaging of Orthopaedic Fixation Devices and Prostheses is a 723-page single volume issued from a well known and authoritative musculoskeletal radiologist, author and teacher, Dr Thomas Berquist. The book is profusely illustrated with 1,900 radiographs, line drawings and tables. The radiographs, scans and tables are of good quality, and they complement the text nicely. Captions and annotations are quite clear. There are no footnotes in this textbook; instead, topics within each chapter are followed by a handful of suggested readings. The book is an updated and condensed version of a previous textbook, Imaging Atlas of Orthopaedic Appliances and Prostheses published in 1994. This earlier text has used as a reference by this reviewer over the past decade.
Imaging of Orthopaedic Fixation Devices and Prostheses is divided into 14 chapters. The opening two chapters serve as a basic introduction to the remainder of the book. The first chapter is a short one reviewing some very basic imaging techniques. Chapter one is only ten pages in length and it is no more than a very superficial treatment of the topic directed to the level of a first year radiology resident. Unfortunately, more detailed information such as how to optimize MR imaging technique in patients with hardware in place was not included. Specific protocols would have been helpful as a handy reference to the practicing physician. The first chapter adds no real value to the book.
The second chapter is a short review of common orthopedic terminology including fracture descriptors, eponyms and the bare bones theory behind basic fixation devices. Screw, pins, plates, rods nails, wires and cables are discussed giving a general overview of the basics and laying the ground work for the expansive and more regionally specific chapters to follow. The chapter would be a worthwhile read for any radiologist tasked to read post-fixation studies, and it should be read prior to delving into the succeeding chapters.
Chapters 3-13 are organized as region oriented discussions. Trauma, prosthetic devices, fixation and orthopedic procedures for each anatomic area are discussed. Classifications of orthopedic fractures are included where indicated. The final chapter, Chapter 14, deals with the surgical procedures and orthopedic devices and implants associated with musculoskeletal neoplasia.
Chapter 3 would be the chapter of the most direct interest to neuroradiologists as it deals with the spine. Spinal instrumentation techniques have dramatically expanded over the past decade and imaging plays a vital role in both preoperative and postoperative evaluation. New and innovative hardware such as various disc replacement options some of which are unfamiliar to most practicing radiologists are illustrated. There is an informative and concise synopsis of scoliosis focusing on radiographic diagnosis, fixation devices and their complications. Spondylolisthesis and degenerative disease including enumeration of surgical approaches to cervical, thoracic and lumbar disease are discussed. The chapter ends with a section on trauma involving each segment of the spine.
Imaging of Orthopaedic Fixation Devices and Prostheses is not a comprehensive review of all possible orthopedic devices currently in use nor is it intended to be. The text discussions are to the point, but they are limited, often leaving the reader wanting more information. The book does provide suggested readings for each topic if athe reader wishes to investigate further. The book is well organized, remarkably well illustrated and full of useful information presented in a readily accessible form. Imaging of Orthopaedic Fixation Devices and Prostheses would be a good book for any radiology group to purchase as a reference text. Radiology residency programs should consider this book as an addition to their library. For the radiologist who wants to increase their understanding of orthopedic devices, the purchase of this book would serve as a fine beginning towards producing more meaningful reports.
