Challenging Cases in Musculoskeletal Imaging

Freyschmidt J. Challenging Cases in Musculoskeletal Imaging. Thiemes; 2015; 416 pp; 1438 ill; $164.99

freyschmidt_musculoskeletal-imag_coverWhile written primarily for those in musculoskeletal radiology or radiology training, there are instructive cases in this book involving spine, pelvis, and skull imaging.

Written by Professor Freyschmidt, this 370-page hardcover book covers all musculosketelal anatomic areas. The neuroradiologist will be interested in the first half of the book, where the skull is covered in 25 pages and 16 cases, the spine/sacrum in 67 pages and 30 cases, and the pelvis in 68 pages and 31 cases. The structure is quiz-based, and cases are illustrated and described. There is a similar presentation form from case to case: history, radiologic findings, anatomic and pathology background, possible etiologies, synopsis and discussion, and final diagnosis.

The mixture of cases range from reasonably common to difficult to very challenging. What is educational are the explanations of the findings in each case. The material does not include evaluation of the brachial plexus or the lumbosacral plexus but concentrates on osseous evaluations with all modalities.

Cases are discussed in an informal, nearly conversational manner in which the author as part of the differential diagnosis asks a question and then answers it. During these discussions and presentations, unusual facts or postulates pop up, such as that Paget disease is endemic in northern Germany but rare in southern Germany (go figure) and that the lytic phase is initiated by viral infection. Also, who has heard of the “India-rubber” sign or even what India rubber is? Had to Google that one. Some unusual cases such as cervical spine and pelvic melorheostosis are shown; more careful editing here and in other places in the book are called for. The history describes a 28-year-old man, but the legends attached to that case (#17) identifies a 65-year-old woman. Other unusual entities, such as what is labeled a notochordal hamantoma (not a chordoma), are shown, in addition to intraosseous ganglion, vertebral body LCH mimicking an acute Schmorl node, calcifying discitis, myositis ossificans mimicking other entities, disseminated cystic angiomatosis, seronegative spondyloarthropathies, SAPHO, Gorham-Stout disease, and herniation pits, among others. The cases selected for this book, apparently, are those that were of concern to either the radiologists or the referring clinician or were difficult diagnoses to make.

This would be a reasonable purchase for a departmental library, particularly as relates to a resident or fellowship training program.

Challenging Cases in Musculoskeletal Imaging
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