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Book review |
This book has expanded from a good 1st edition of 245 pages to an excellent 2nd edition of over 400 pages. The addition of an interactive CD with a study guide to facilitate full understanding on a chapter-by-chapter basis is excellent. The CD also contains some good reference files and everyday useful hints.
The first chapter gives an overview of the history of the change in technology. Chapter 2 is a very concise informative description of all the anatomies involved and explains some of the complex anomalies which may affect densitometry results. Chapter 3 is a simple explanation on statistics and is a better, more easily understood offering than it was in the first edition.
Chapters 4 and 5 deal with Quality Control very effectively and explain the need for good daily quality assurance and also the effect that scanning patients on different machines will have on the validity of the data but also attempts to show how those comparisons can be made.
Chapter 6 is full of information to help the densitometrist clinically in detailing the effects of diseases and drugs on bone density taken from medical literature and extensively referenced. This is great expansion on the first edition.
Chapter 7 is a review on the indications and clinical guidelines for selecting patients and it has to be noted that as this is an American Publication therefore this chapter will have limited use in the UK due to the differences in our means of provision for screening tests in the NHS. That said, the practitioners among us here in the UK will not disagree with the guidelines but we may well yearn for the opportunity to match them in our own clinical departments.
Chapter 8 has a wealth of information for the self-assessment of risk to precipitate referral for densitometry. This is aimed at use by the patient, a concept we may find difficult to implement in the UK with the restrictions that IR (ME) R puts on self-referral. The indices are useful in showing individuals the need for their own lifestyle to change to lower the future fracture risk.
Chapters 9, 10 and 11 deal with the practical aspects of scanning and monitoring the results and should be kept close by when scanning as a reference tool on a daily basis.
Chapter 12 is a new addition, and reflects the changing role of the densitometry team.
A technical report showing an array of numbers is no longer good enough, a detailed analysis of risk, T score, diagnosis, treatment recommendations and follow up arrangements to monitor treatment is now the norm. This chapter reminds all of how complex the issue if scan interpretation is.
Chapter 13 is again is more relevant to the USA than the UK but it is interesting to note that there seem to be very few devices that do well in UK if they have not had FDA approval in the USA. It also serves as a good quick reference to the capabilities of a device you may be unsure of.
This book is comprehensive and up to date will prove useful in the primary care sector, the secondary care sector, is a handbook for radiographers, technologists and nurses performing scans and should be in use daily not put on a shelf in the library.
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