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Orthopedic nuclear medicine. By A H Elgazzar, pp. xii+240, 2004 (Springer-Verlag, Berlin, Heidlelberg, New York) £115.50 ISBN 3-540-00614-1

Let me start with my conclusion. This text is a tour-de-force: a single author 240 page text book covering the whole of radionuclide imaging with respect to bone and joint diseases, and including over 1000 references. This title underplays the range of the book. In addition to orthopaedic surgical conditions all medical conditions involving bones and joints such as arthropathies, diffuse metabolic/endocrine disorders and congenital disease are also covered.

The book is superbly illustrated with both colour and line diagrams, anatomical drawings, radiographs, scans, and both gross and histological pathology. There is extensive correlative imaging of anatomy with pathology, imaging with histology etc. Cases illustrated are all well proven and the quality of the isotope imaging in particular is superb.

The text is extraordinarily comprehensive. Every topic that I chose to challenge the book with was identifiable in the index with a good description on the relevant pages and usually well-illustrated. The anatomical and pathological text and diagrams go far beyond that normally expected for a nuclear medicine text but for that very reason this is an excellent teaching tool for radiologists and nuclear medicine physicians who may not have had prior orthopaedic or rheumatological training.

Topics covered include basic science bone and joint diseases, inflammatory bone diseases, diffuse bone disease (metabolic endocrine and congenital), trauma, neoplastic, and joint disorders with addition chapters on soft tissue calcification and the therapeutic use of radionuclide. The text is up-to-date and contemporary for example describing the use of white cell/colloid scans and FDG PET in imaging of bone infection.

The text integrates the role of nuclear medicine within the clinical scenario and provides a realistic perspective of its place with respect to other imaging or investigative modalities and without the bias or lack of proof often seen in nuclear medicine books.

As I indicated in my opening sentence I believe this text is a remarkable work benefiting from the author's clearly considerable practical experience and enthusiasm. It is a cliché but this book should be available as reference in all nuclear medicine and radiology departments and probably in orthopaedic and rheumatological ones also. It should be obligatory reading for trainees in imaging especially those specializing in radionuclides.

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