British Journal of Radiology (2003) 76, 210
© 2003 British Institute of Radiology
doi:
Radiological electronic atlas of malformation syndromes and skeletal dysplasias (REAMS). By C M Hall and J Washbrook, CD ROM, 1999 (Oxford University Press, Oxford, UK), £435+VAT ISBN 0 19 268593 7
R Kerslake
This electronic atlas (REAMS) is a brilliant resource for those with an interest in skeletal dysplasias and malformations. Drawn from the extensive collection and expertise of Great Ormond Street Hospital for Children, it provides over 6000 images covering more than 200 conditions (encompassing more than 80% of those seen at Great Ormond Street, according to the publisher).
The huge advantage of the electronic format is the ease with which the database can be interrogated and viewed in a non-linear manner. Searching, cross-referencing or sorting by condition, body part, radiological findings, radiological view and age (amongst others) is rapidly, simply and intuitively achieved. The interface encourages browsing through the varied, complex and interesting material. For each condition, there is a concise description of the main clinical and radiological features with helpful references to the recent published literature. A list of radiological findings and synonyms is also provided.
The images, which are stored and displayed in jpeg format are, for the most part, of good quality. In a few, there are compression artefacts or the key findings are inconspicuous or not displayed to best advantage. Unfortunately, there are no controls for altering the displayed image settings (though this can be achieved in independent graphics programs, if one can identify the relevant image on the CD). Some images are annotated and clicking on the accompanying text will then highlight arrows on the corresponding images. Images can be displayed as thumbnails or enlarged for optimal viewing.
The REAMS program and images are provided on a single CD ROM. The publisher's website indicates that, by default, the program and data are installed completely to the hard disk, enabling it to be used without the CD-ROM in the drive. This is not the case, though it is easy to transfer the images from the CD to a local directory from which they may be read. However, the brief soft-bound user manual does not provide instructions on how to do this. The program has been designed to operate on Windows 95, 98 or NT4 on which it seems to run rapidly and without problems; those using more recent operating systems may apparently require specific file permissions to install and run the program – a Mac version is not available. There is limited on-screen help but on-line features are lacking.
What would improve this? A web-style interface might prove even easier to use and on-line links to literature references and updates would be useful. In a new version, the images might be stored in a loss-less format (perhaps on DVD) and the ability to manipulate image contrast and brightness would help. In other respects, I would change little – the content is excellent and this material clearly fulfils its intended role as a reference resource and teaching aid for radiologists, orthopaedic surgeons, clinical geneticists and paediatricians. It is not cheap, but the cost is very reasonable considering the wealth of material and ease of use for this limited specialist market.
