The Orthopaedic Physical Examination.

The Orthopaedic Physical Examination Reider B. Philadelphia, PA 19106, WB Saunders Co, 1999, hardcover, 402 pp, illus, ISBN: 0-7216-7437-2, $49.95.

This text was written because the author needed an up-to-date resource to complement his lectures to health care practitioners and students. As he stated in the preface, the book's purpose is 2-fold: (1) to define fundamental terms and describe the most basic tests and measures for beginning students in the health care field and (2) to discuss advanced and supplementary examination techniques for the knowledgeable practitioner who needs a review.

The general organization of the book and specific content within each chapter flow simply and logically. There are a total of 9 chapters, with 8 chapters organized according to body region. Chapter 1 provides operational definitions of the basic terms and generic examination techniques that are used throughout the text. A minor disappointment in the first chapter is the author's dated version of selected terms used for observational gait analysis (eg, using "heel-strike" rather than "initial contact" to describe the initial subphase of walking). A nice feature of chapter 1 is that it provides a framework for the organization of all the other chapters. Thus, for each major region of the body, the author describes the procedures of inspection (surface anatomy) and evaluation of body alignment, range-of-motion testing and measurement, palpation, gait analysis (when appropriate), manual muscle testing, sensory testing, and special tests. Generally, the material on each body region is comprehensive; however, coverage related to the motion testing and the syndromes of the cervical, thoracic, and lumbo-sacral regions is less comprehensive, even for beginners. The text is easy to read, is complemented by numerous strategically placed photographs, and is supported by many references that reflect 3 or 4 decades.

This text has some features that make it unique. Although a detailed review of functional biomechanics is not given, the author provides a perspective on the overall function of specific regions. For example, with regard to the elbow and forearm region, he states that "by flexing and extending, the elbow allows an individual to decrease or increase the functional length of the upper limb, producing great flexibility in positioning the hand in space," and "the remarkable ability of the forearm to pronate and supinate allows an individual even greater variety in positioning the hand and wrist, while permitting complex rotational tasks that would otherwise be awkward or impossible." Although the anatomy reviews are brief, they are effectively combined with photographs of living individuals, providing a more realistic approach to studying surface anatomy. In addition, the author has threaded interesting and useful clinical insights and conditions associated with abnormal examination findings throughout the book. Finally, the book provides tables that summarize the physical findings of several of the most common clinical conditions for each body region. These tables could be an extremely useful quick reference tool.

This author did not stray from his intended purpose. Therefore, this book should be quite useful for the health care practitioner in a more generalist setting or for beginning specialists in orthopedic medicine or physical therapy who are seeking basic orthopedic diagnostic tools. I do not believe that the experienced practitioner would find material in this text especially enlightening. I would not recommend this is a primary text for physical therapist students because it does not have enough detail in such areas as history taking and arthrokinematic examination.

Gordon J Alderink, PT
Grand Valley State University
Allendale, Mich

Mr Alderink is Assistant Professor in the Physical Therapy Program, where he teaches biomechanics and orthopedic differential diagnosis. He is also Director of Academic Research at the Center for Human Kinetic Studies, a motion analysis laboratory.