Hip Disorders in Childhood (Clinics in Developmental Medicine No. 160).

Hip Disorders in Childhood (Clinics in Developmental Medicine No. 160) Banta JV, Scrutton D, eds. London, WC1V 6RL, United Kingdom, Mac Keith Press, 2003, hardcover, 282 pp, illus, ISBN: 1-898683-33-6, $75.

The purpose of this text is to familiarize the reader with aspects of hip growth and development, examination, and some interventions for various hip pathologies in the pediatric population. Although the contributing authors are from the United States and England, the issues of pediatric hip disorders are universal in nature. Half of the authors are orthopedic surgeons; the other authors include a rheumatologist, a radiologist, an orthotist, and a kinesiologist. The authors' intended audience includes general physicians, pediatricians, physical therapists, and other types of clinicians who examine and treat pediatric patients.

Chapter topics include anatomy (including embryological development), physical examination, radiologic examination, gait examination for hip function, orthotic management, and a wide variety of common and unusual disorders of the pediatric hip. Although this text only addresses the pediatric hip, it is comprehensive in scope and easy to follow, and each chapter is short and succinct (7-21 pages), which helps to keep the reader's interest.

The chapters contain numerous illustrations, photographs, and radiographs that help the reader visualize hand placement during examination procedures and that illustrate positive examination results and tissue anatomy and pathology of the various pediatric problems. Interestingly, chapter 3, "Radiology," had no image comparisons or illustrations. Each chapter has a lengthy reference list that is drawn mostly from peer-reviewed articles; however, only about a third are less than 10 years old.

The chapters regarding specific diagnoses are well organized. Most include the components of commonly used terminology (diagnosis-specific), incidence and prevalence, presentation, differential diagnoses, and management (eg, physical, pharmaceutical, surgical). Some of the chapters include prognostic factors and outcome studies. The following diagnoses have chapters of their own: developmental dysplasia of the hip, the painful hip joint, slipped capital femoral epiphysis, Perthes disease, epiphyseal dysplasias, trauma, juvenile idiopathic arthritis, cerebral palsy, myelomeningocele, and muscle weakness disorders. The last chapter of the book discusses "unusual disorders," which includes arthrogryposis, hemophilic arthropathy, hip dislocation in children with Down syndrome, sickle cell disease, proximal femoral focal deficiency, and chondrolysis of the hip.

For physical therapists, this book is a great reference that will enhance their understanding of how the hip is affected by a variety of pediatric conditions, how the problems are typically examined, and the appropriate treatments. The text, however, does not give specific treatment options that are expressly for the physical therapist. Appropriately, intervention needs to be tailored to meet the needs of each patient. Understanding the signs, symptoms, mechanics, and other medical treatment alternatives will enable the physical therapist to make informed clinical decisions.

Overall, the text is well organized and meets its stated objective of helping the health care professional examine and understand the pediatric problems of the hip joint, which is hard to palpate, and the many sources of hip pain and gait abnormalities. Hip Disorders in Childhood is easy to read, and each chapter can stand alone. This is not a text that should be required in physical therapist professional education programs; however; it is a rich addition to a pediatric physical therapist's professional library.

Jennifer L Lander, PT, EdD Armstrong Atlantic State University Savannah, Ga

Dr Lander is Associate Professor in the Department of Physical Therapy and provides evaluation and intervention services for "Babies Can't Wait," an early intervention, Part C program.