Rheumatology for the Health Care Professional

Rheumatology for the Health Care Professional Spiera H, Oreskes I. St Louis, MO 63132, Warren H Green Inc, 1991, paperback, 369 pp, $42.50.

The authors state that the chief purpose of their book is to enhance the understanding of multiple nonphysician health professionals who have similar aims in the rehabilitation of the person with a rheumatic disease. This text is written for health professionals who have had little opportunity to gain knowledge about rheumatic diseases and are treating such patients; for those with peripheral interest in the arthritides; for undergraduate students in the health disciplines; or for medical students, residents, and physicians with minimal training in rheumatology. There are 28 chapters written by over 30 contributors, some of whom are illustrious individuals in the field of rheumatology. The text contains a glossary and the current American College of Rheumatology Classification of the Rheumatic Diseases. There are very few illustrations. The first three chapters are devoted to the biology of systems involved in the rheumatic diseases including the joints, the process of inflammation, and the immune system responses characteristic of various rheumatic diseases. Chapters 4 through 12 are devoted to describing the more common arthritides encountered in clinical practice, including rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, gout, diffuse connective tissue disease, variants of rheumatoid arthritis, bone disease, local musculoskeletal conditions such as bursitis and tendinitis, and infectious arthritis. Chapters 13 through 19 describe the therapeutic process, incorporating the diagnostic process, medications, rehabilitation medicine, physical therapy, occupational therapy, and social work. The remaining chapters describe social, psychological, and cultural issues related to the patient, family, and health care provider. Chapter 27 examines the formal educational process of various health professionals in general terms; however, no attempt is made to identify rheumatology training in any group other than physicians. Upon initial reading of the purpose of this text, one might be tempted to jump to the conclusion that this book is trying to be all things to all people. On closer review, however, the authors have presented a book that achieves their purpose of reaching a cross-disciplinary audience interested in the treatment of rheumatic diseases. It reads much like a primer on the topic. With respect to physical therapists, the book would be of most interest to entry-level students or to individuals who have minimal experience with the area of rheumatology and who wish to update or familiarize themselves with this particular kind of patient. Given that individuals with arthritis are sometimes significantly affected with respect to their vocation, a chapter on work-related issues and vocational rehabilitation options would have been useful. The chapter on physical therapy reflects traditional thinking regarding the treatment of persons with rheumatic disease. It would have been helpful if the author had given a suggested reading list of articles or texts written by physical therapists. Most of the suggested reading for this chapter is written by physicians or providers other than physical therapists. In recent years, more therapists have been contributing literature that pertains to physical therapy management of rheumatic diseases. This chapter does provide an overview that will be useful for the audience intended; however, a therapist who desires more detailed information in the treatment of arthritis will have to do a more thorough search of the literature. Overall, faculty of physical therapy programs who wish their students to receive an overview of rheumatic diseases in a readable and understandable format will find this text suitable.

Carolee Moncur, PhD, PT Univ Of Utah Salt Lake City, Utah