Orthopaedic Clinical Examination: An Evidence-Based Approach for Physical Therapists.

Orthopaedic Clinical Examination: An Evidence-Based Approach for Physical Therapists Cleland J. Carlstadt, NJ 07072, Icon Learning Systems, 2005, paperback, 516 pp, illus, ISBN 1-929007-87-6, $64.95.

The stated goal of this textbook is to serve as a supplement in academic musculoskeletal evaluation courses and also to provide a quick reference guide for clinicians who want to enhance their ability to incorporate research evidence into their clinical decision-making process. The intended audience for this book includes educators, students, and clinicians involved in the examination of patients with musculoskeletal impairments.

This book contains 12 chapters. The first chapter introduces the evidence-based practice paradigm and reviews statistical concepts and measures relevant to reliability, diagnostic accuracy, and predictive validity. The second chapter deals with search strategies and subsequent critical evaluation of articles on diagnostic utility. The theoretical concepts introduced in these first 2 chapters are clearly illustrated th tables, figures, and clinical examples. The remaining 10 chapters are each devoted to a specific region of the body. Each chapter starts with a review of osteology, arthrology, myology, and neurology. This is followed by a review of data on the reliability of measurements from the patient history and physical examination. All chapters end with a discussion of data on diagnostic accuracy of relevant tests and measures.

The book is illustrated with 169 high-quality, full-color Netter and Netter-style drawings and 173 color photographs. Throughout the book, 281 well-organized tables provide an easy overview of quantitative data on reliability and diagnostic accuracy of specific tests and measures. The tables also provide easy-to-follow information on the performance and scoring of each test and measure. Data on patient population and the reference standard used are included in all tables, which allows readers to determine external validity with regard to their own clinical situation. An appendix includes a clear description of performance and scoring of additional orthopedic tests that have not yet bad their psychometric properties investigated. An index at the end of the book allows for quick access to relevant data.

To my knowledge, this book is the only text available that combines clear yet concise descriptions of orthopedic test performance and scoring with data on the psychometric properties of these tests and measures. The text translates relevant statistical concepts to the clinical situation but is not meant to replace more in-depth textbooks on statistics and methodology. New research is continuously being produced in the area of reliability and diagnostic accuracy of orthopedic tests and measures, which will surely date the text. However, the text is as comprehensive and the references are as up-to-date as can be expected. This book is well written and well organized and the tables, figures, and photographs greatly enhance the text and make the information quickly accessible to the reader. In summary, this book most certainly meets its stated goals, making this the most logical choice for a required text for a musculoskeletal evaluation course. It also will undoubtedly serve as a much-used, clinically useful reference text for every student, educator, and clinician involved in musculoskeletal care.

Peter A Huijbregts, PT, DPT, OCS 

University of St Augustine for Health Sciences

St Augustine, Fla

Huijbregts is Assistant Professor of Online Education, teaching courses in orthopedic basic science, research, and spinal instability. He also is a clinical consultant at Shelbourne Physiotherapy in Victoria, BC, where he primarily treats patients with spine-related conditions and is an educational consultant for Dynamic Physical Therapy in Cadillac, Michigan.