Focus on x-rays

Here is another useful WHO publication. It stays close to the topic of pattern recognition through most of its 205 pages, but it does enter the field of radiography to emphasise issues of quality and safety — a relevant reminder, since many in its target audience would be involved closely in taking x-rays.

In this era of CT and MRI, plain x-rays are often overlooked in favour of high technology solutions, but in rural areas they remain the mainstays of diagnosis. Many readers will enjoy having access to a book that addresses this topic, without having to pay for a tome which also describes how to interpret digitised images. For the generalist doctor who has to interpret his or her own x-rays, it provides a useful primer.

The book is organised into sections on the chest, musculoskeletal and gastrointestinal/urinary systems. Each chapter is well set out, with learning points providing a succinct summary at the end. This systematic approach provides a good collation of standard approaches to the assessment of such areas as the cervical spine.

The patterns alluded to in the title are patterns of disease rather than radiographic patterns. The disease-based approach provides a practical compromise for the clinician. There is an emphasis on tuberculous disease which reflects the South African origins of many of the authors, and this means that the book has practical applications in many developing countries where the disease is rife.

The lack of an index is a deficiency, although the systematic approach of the book allows the reader to find the relevant area reasonably easily. The photographs and line drawings are generally of a high standard but some, especially in the musculoskeletal section, lack sufficient annotation. The inclusion of renal ultrasound seems out of place.

The book would be a useful text for those entering rural or remote practice, or practice in the developing world. This is especially true for those in training or early in their career as it provides a useful framework of patterns of disease, which will augment their knowledge base and help them organise their experience.

Alan B ChaterRadiological Advisory Council of Queensland