Causes and meanings of signs
Author: Sarah J Abrahamson
Published online: 7 May 2012

DID YOU KNOW that the McMurray test has been shown to have a specificity of 86% and a sensitivity of 48% for meniscal injury? This text describes a wide range of such clinical signs and also evaluates them for effectiveness, adding invaluable detail not available in other clinical texts.
The three authors, two of whom are from Australia, are resident medical officers who saw a need for such a work, and then consulted a huge range of senior colleagues and references in the development of this book. They have produced a text that will be useful for clinicians in many adult medical and surgical specialties, for medical students and for those involved in teaching medical students.
Several small points could be improved in future revisions of this generally very thorough work. Little mention is made of common developmental conditions that could cause these signs, even in adults, such as cerebral palsy. The addition to the Neurology Section of the Glasgow Coma Scale, of pragmatic and prosodic speech deficits, as seen for example in non-dominant cerebral lesions, and more mention of the possible role in producing some signs of psychological conditions and traumatic brain injury would be useful. The peripheral vascular system and common paediatric signs could also be added, as could a brief discussion of the clinical epidemiological terms used.
Overall, this book is a very useful reference and presents good value, and I will certainly be using it, as well as recommending it to medical students and specialist rehabilitation trainees.
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