Tunnel Syndromes.

When I first learned of the publication of this book, I was very excited. I looked forward to a textbook filled with insightful information about assessment, clinical management, and treatment intervention for clients who have peripheral nerve involvement due to constriction at or about the anatomic tunnels. After reading the book, however, I was very disappointed.

The table of contents portrays tunnel syndromes in three parts: upper extremity, lower extremity, and in athletes. Each syndrome is described by the anatomy, etiology, clinical symptoms and signs, and treatment. Various anatomic illustrations accompany the text. The first section describes the relevant anatomy of the region, along with a description of the peripheral nerve passage through the tunnel. The etiology section presents a literature review specific to the problem, along with specific assessment mechanisms used to differentially diagnose the syndrome. The clinical symptoms and signs section includes both the objective and subjective description of relevant clinical traits. The last section describes treatment through either surgical intervention or physical therapy.

In the first part, the authors address 20 different upper-extremity tunnel syndromes. The described syndromes range from clinically common disorders, such as carpal tunnel syndrome, to those syndromes that are more obscure and infrequent, such as tendinous arch of the adductor pollicis muscle.

Part 2 presents 13 lower-extremity tunnel syndromes in the same format as those of the upper extremity. The clinical presentations of common entrapment neuropathies (eg, piriformis muscle syndrome and anterior tarsal tunnel syndrome) are compared.

The last part presents a brief overview of entrapment syndromes associated with athletics. The athletic-related syndromes described are the same as those noted in the upper- and lower-extremity sections, but have athletic events as a possible cause. I find these presentations to be a curious addition as a separate section. as all of the material could have been handled in either of the two main sections of the book.

I do have some concerns about the technical aspects of this book. The proofreading for errors in spelling, typing, format, and consistency is poor. "Physical therapy" and "physiotherapy," as well as "electrodiagnosis" and "electromyography," for example, are used interchangeably throughout the text with no thought to consistency.. Spelling errors and typographical errors are prevalent.

In general, this book lacks attention to detail. The references are presented without mention of the manuscript title. This practice is particularly annoying when trying to obtain the article from the library. The figures are amateurish, lacking definition or depth. The numbering system used to identify landmarks is difficult to follow because the legend contains both the reference number and the landmark. The figures selected do not add to the clarity of the textual material. The sections within each syndrome discussion are too brief, leaving the reader confused. Some anatomic descriptions are outdated, and the etiology, section often contains information that is of little value because of awkward sentence structure. The lack of specific assessment descriptions makes assumptions that all studies are done the same way. The treatment section uses generic terms. The term "physical therapy," for example, is used instead of the specific terms describing the intervention used by the physical therapist.

This book may be of limited use to the practicing therapist who has a strong background in anatomy and neurology. The doctoral-level student may find this book a good place to start literature searches, but it is not useful for in-depth review of material. This book may be useful for a university library, but considering its price, it would not be a cost-effective purchase for a home or office library.