Davis KW, Blankenbaker DG. ExpertDDX: Musculoskeletal, 2nd Edition. Elsevier; 2018;968 pp;3,100 ill; $299.99.
Expert DDX: Musculoskeletal, 2nd Edition is the second book in the ExpertDDX series. The series addresses a challenge inherent to reference books of differential diagnoses. The authors, Kirkland W. Davis, MD, and Donna G. Blankenbaker, MD, provide a resource that balances conciseness and comprehensiveness.
Dr. Davis and Dr. Blankenbaker are both professors of radiology and prolific researchers at the University of Wisconsin School of Medicine and Public Health. By writing a volume of ExpertDDX series specific to the musculoskeletal system, the authors have produced a user-friendly and specialized compendium.
This book is divided into 3 parts, all based on anatomy, imaging, and clinical. The first part is divided by anatomic location, the second part by imaging modality, and the third by clinical complaint (i.e. “shoulder and arm,” “spine,” and “systemic.” All modalities including radiography, CT, MRI, and ultrasound are covered.
The way the text is organized allows the reader to use different origins of inquiry and cross-reference their findings. For example, a novice user may begin with a specific anatomic location and correlate with clinical complaint. Alternatively, in a particularly difficult case, the reader may benefit from beginning with the clinical complaint and cross-referencing with imaging by modality.
Over 200 differential diagnosis lists are presented. Each list is divided between common, less common and rare, but important diseases. Following the differential diagnosis list, key differential diagnosis issues and helpful clues are provided. The former provides details differentiating the factors pertinent to a correct diagnosis, such as age, location, or pattern of spread. The latter describes defining features of specific diagnoses such as common, less common and rare.
The inclusion of “key differential issues” and “helpful clues” is particularly thoughtful. While lists of differential diagnoses can be found in various resources, the deciding factors that allow the clinician to arrive successfully at the diagnosis require more careful consideration. In this regard, the authors do a superlative job. For example, in delineating between soft tissues masses of the foot, the authors remind that while radiographs demonstrate adjacent osseous changes, MRI is the modality of choice and ultrasound may be definitive for certain lesions.
In more than 968 pages, thousands of high-resolution images of pathologies are provided. Most images are marked with arrows to indicate the location of findings. Brief descriptions are provided in the margins that further characterize the findings. The textbook is supplemented by the electronic version which offers more in-depth analysis of pathologies.
While the number of images is impressive, this book would likely have benefited from further discussion of the images presented. Restricted by the size of the margins, the authors decided to include only 1-2 sentences per image. Further integration of the material found in the electronic version would have made the text a stronger learning tool, rather than a reference book.
Another potentially useful inclusion would be a section that spotlights musculoskeletal emergencies or findings that require timely intervention. Such a chapter could be included separately or perhaps integrated into the images across sections, ensuring that clinicians are aware of the most emergent radiological findings.
In summation, ExpertDDX: Musculoskeletal, 2nd Edition is an exhaustive reference for radiologists of all levels. The textbook is probably most useful for beginning-to-intermediate radiologists as it provides little depth. However, a more advanced radiologist would likely appreciate a deeper, more integrated approach for further learning. As a resource for differential diagnoses of radiological musculoskeletal findings, the authors no doubt succeed in providing a volume that is both comprehensive and usable in clinical practice.
