Yu E, Jaffer NM, Chung TB, Naraghi AM, Rajan DK, O’Malley ME, Rogalla P, Murphy K, eds. Emergency Radiology. RadCases. Thieme; 2015; 224 pp; 489 ill; $59.99
Case review books and series have a long history in radiology, nearly universally encountered during residency in preparation for our board examinations. Even though the board format has recently changed, you will still see residents with case review books and their electronic equivalents. Perhaps with the adoption of MOC, more seasoned radiologists will also turn to such books and databases prior to the MOC exam. It certainly seems that the number of case review selections appears to be increasing, both in written text and in online format. The topic of emergency radiology is one of the newer entries in Thieme’s RadCase series, now totaling 12 subspecialty topics in print. An emergency radiology case review book will be inherently somewhat different from the other subspecialty topics offered in such a series, as it cannot focus on just one body system or imaging modality but instead will have to cover a wide gamut of topics and modalities encountered on the front lines of our specialty.
RadCases: Emergency Radiology tackles these challenges with an understated but recognizable organization. While a table of contents doesn’t explicitly list divisions within the book, and in fact, none actually exist, the cases progress in an orderly fashion, beginning with neuroradiology cases. About one-quarter of the 100 cases presented in the book are neuroradiology-based. The balance of the book introduces a few vascular cases (≈5) with the remainder of the cases split roughly evenly between musculoskeletal, body, and thoracic topics. In such review books, case selection should be the preeminent concern, and in this particular book the collections of cases within the different divisions is not consistent.
The chosen emergent neuroradiology cases are nicely varied, covering many important emergent diagnoses with mixed difficulty levels. The assortment of body cases is also well advised, if a little heavily weighted to bowel pathology. The other divisions, unfortunately, include many cases that are too esoteric, particularly the musculoskeletal selections; some of the chest cases can also be accused of this, but they are fewer in number. The book would have benefited by allocating many of the more esoteric musculoskeletal cases to the other topics.
After case selection, the next most important consideration for case review books should be the case presentation. One of the inherent problems with books is the reproduction of conventional radiographs in printed media, a dilemma that the series editors recognize in their foreword. This series attempts to overcome this problem with annotated images in the discussion section of each case; unfortunately, this is only partly successful. There are still a number of cases where the relevant image is a plain film and on which the findings are inherently more difficult to detect. The cross-sectional images are orders of magnitude better, but that is partly attributable to the better reproducibility. Also, though the stated goal is to annotate the images and “take the guesswork” out of the imaging, the editing of the image annotations and accompanying captions was not as meticulous as needed. There are a few images where the annotations and captions don’t match, and a few others where the annotations are either missing or difficult to see.
The case discussions are well thought out and are subdivided into four high-yield sections: differential diagnosis, essential facts, other imaging findings, and pearls and pitfalls. The information in each subdivision is concisely and effectively communicated in bullet format. As with the imaging annotations and captions, the editing for the discussion sections could have been more precise, with typographical and minor content errors scattered throughout the book. The “Further Readings” section of the book is an index at the end of the book listing current references by case, a very nice feature.
Case review books by their nature generally share a similar format and style, with the unknown case presented on one page and the discussion that follows on the next. This book benefits from not following a format of easy to more difficult diagnosis, which often biases the reader to the more obscure choices in a differential. The topic of emergency radiology also allowed wide latitude in case selection, to the benefit of some sections and detriment of others within the book. Online access to another 150 cases is included with the purchase of the hard copy, another valuable feature.
The foreword stated the audience for this book is the young trainee on call and the radiologist taking general call in need of a refresher, and for this particular audience this book is a success overall and should prove useful. A radiologist preparing for the MOC test might also find this constructive. The selected cases within neuroradiology are fairly rudimentary for subspecialists in that field and, combined with the low number of cases, probably don’t justify purchasing the book for a review of that topic alone, but the book could be practical for the neuroradiologist taking general call.
