Case Studies in Chiropractic Radiology.

This book was written by instructors at chiropractic colleges, as a basic text for chiropractic students. Each of the 42 chapters is a case study, and each case study focuses on a common musculoskeletal problem that independent practitioners might encounter in clinical practice. The authors begin each chapter with an account of the patient's history and physical examination and a thorough discussion of the problem being diagnosed. Next they discuss the radiograph findings that were obtained using radiographs, computed axial tomography, magnetic resonance imaging, bone scintigraphy, thermograms, and SPECT bone scans; the demonstrations of each point are excellent. The authors complete each case study by suggesting a treatment program, which usually includes physical therapy and/or chiropractic approaches.

One positive aspect of this volume is that it covers a wide variety of topics in a comprehensive manner. As I worked my way through the book, I found myself becoming more comfortable with radiographic evaluation. Another positive aspect of the text is that the discussions, illustrations, and tecting techniques are all quite current. The discussions of thermography are especially interesting, as are the chapters on scoliosis, thoracic outlet syndrome, and rotator-cuff tears. The references at the end of each chapter are plentiful, and supplemental readings are also included. The treatment approaches are especially appropriate, although the authors state that they are geared to physical therapists and chiropractors, which I found somewhat disturbing. If the authors are saying that chiropractors do "physical therapy," they are definitely out of bounds. Chiropractors do use modalities, and physical therapists do provide joint articulations. but neither profession carries the license of the other, and they should not advertise as such.

On balance, this is an excellent resource book. I find it has added to my base of knowledge in radiology, and I recommend it to physical therapy students and practitioners as a source of information about many of the most common musculoskeletal problems we encounter. Whether chiropractors are qualified to order and interpret radiographs is a question that can be addressed by others. I would like to suggest that the authors examine the work of Robin McKenzie, because they ignored the concept of extension for lumbar disk syndrome. Another area of interest they might have included is carpal tunnel syndrome.

Jim R Jones, PT Gallup Indian Medical Center Gallup, NM