Czervionke LF, Fenton DS. Imaging Painful Spine Disorders. Elsevier Saunders 2011, 672 pages, 400 illustrations, $149.00.
Books in Radiology, and particularly in Neuroradiology, have evolved over the years from general textbooks (for example “Neuroradiology”) to subspecialty textbooks (for example “Head and Neck Radiology”) to diseases (e.g. Stroke Imaging) to symptoms (this book “Imaging Painful Spine Disorders” is one example).
Written exclusively by Drs. Czervionke and Fenton, 79 chapters cover both normal anatomy and nomenclature for disc disease (5 chapters), followed by major spinal disorders (74 chapters), each with a specific disease which may result in pain. One could quibble with putting some of these entities, such as spinal cord infarction (chapter 69), in a book dealing with spinal pain since the main presentation is not pain but an acute neurologic deficit.
There are other examples where the disease under consideration may or may not be associated with pain, such as epidural lipomatosis or arachnoid cysts. In any event, the fact that two neuroradiologists wrote the book in its entirety gives it uniformity and a smooth style of composition.
Each of the 74 clinical chapters begins with a short history (clinical presentation), followed in order by imaging presentation, discussion, imaging features, differential diagnosis, treatment, and references. In essence, the authors use a single case as a starting point to discuss entitles with a nearly similar presentation. Take the chapter on myelitis as an example. Here the signature case is one of a 33-year-old woman with NMO, and the authors nicely compare the disease to MS and discuss possible etiological factors. In the discussion of the differential diagnosis, acute transverse myelitis, compressive lesions, radiation myelopathy, cord neoplasms, and abscess of the cord are compared.
In the ensuing discussion of anterior and posterior cord abnormality (still in the same chapter as the NMO) we read of spinal cord infarctions, MS, ADEM, subacute combined degeneration, and HIV myelopathy. It was a bit surprising to this reviewer that neither in this chapter, where a case of infarction is shown, nor in the chapter devoted to spinal cord infarction do the authors show DWI of the cord. That sequence is often helpful in solidifying the diagnosis, and, in fact, in spinal cord abscesses or extramedullary abscesses (or in a suspected abscess) DWI is also helpful. The opportunity to demonstrate the power of that technique was missed.
The images shown in general are excellent and of high quality, but readers (particularly neuroradiologists) would, I presume, liked to have seen in the chapter on gliomas some DTI/tractography images which could show tract invasion vs. tract displacement. This does not detract from the book but more advanced techniques certainly are ones which any future edition of this text should include.
The opening chapters on cervical, thoracic, lumber, and sacral anatomy are standard fare, and the chapter on lumbar disc herniation/disease could be valuable for those unfamiliar with the definition and lexicon used.
The way the book and chapters are set up allows one to review images of many common and uncommon spinal disorders. It is in that respect a good review.
The straightforward nature of the book with the inclusion of basic information and well labeled and well described images would make this a useful reference for clinicians and trainees in radiology/neuroradiology.
