A CLINICAL GUIDE TO PRIMARY BONE TUMORS. Jerome Levesque, Robert G. Marx, Robert S. Bell, Jay S. Wunder, Rita Kandel, and Lawrence M. White. Baltimore, Williams and Wilkins, 1998. $99.00, 301 pp.

Aboulafia, Albert J. M.D.

Journal of Bone & Joint Surgery - American Volume:
Book Review

    During the last three decades, the evaluation and management of patients who have a primary malignant bone tumor has evolved immensely; thus, there is a need for a condensed text related to this subject. Dr. Levesque and Dr. Marx, two postgraduate students working with Dr. Bell, compiled an extensive set of handout notes for their fellow residents; these notes became the preliminary draft of this text. The authorship was extended to include Dr. Wunder, Dr. Kandel, and Dr. White from the University of Toronto Musculoskeletal Oncology Unit.

    Part 1, which deals with the clinical and radiographic aspects of musculoskeletal tumors, will be useful in the management of patients who have an undiagnosed tumor. This section includes four chapters, the first of which describes the presenting symptoms. The second chapter addresses radiographic analysis and provides “seven questions to ask” when evaluating a bone tumor. The other two chapters cover the differential diagnosis, staging, and biopsy of these tumors. The information in this section is concise, clear, and well organized.

    Part 2 provides a clinical, radiographic, and pathological description of seventeen benign and ten malignant bone lesions as well as seven lesions that mimic tumors. This section will be helpful when the diagnosis is known or strongly suspected. The organization of the material is consistent: a general description of the biological characteristics and prevalence of each lesion is followed by a discussion of the presenting symptoms, physical findings, radiographic appearance, differential diagnosis, pathological characteristics, treatment, and complications. The radiographic and histological images are clear and represent the typical appearances of the described lesions. The authors often use a bulleted format, which allows a great deal of information to be imparted concisely.

    The intended audience includes residents in orthopaedics, radiology, and pathology as well as general orthopaedists and primary-care physicians. The book is not meant to be a definitive reference; rather, it is intended to serve as a practical guide for those seeking an overview of primary bone tumors. The references are appropriately limited and well selected. The entire book can easily be read in one sitting.

    The authors have done a remarkable job of organizing a concise text on a topic that provokes fear and anxiety in both patients and physicians. The recommendations regarding imaging studies, biopsy, and treatment are not controversial and are based on accepted practice as well as the authors' extensive experience and expertise. This book will be invaluable for any physician who currently manages (or anticipates managing) patients who have a bone tumor. It will help not only in evaluating these patients but also in directing them toward timely and appropriate treatment.

    Albert J. Aboulafia, M.D.

    Department of Orthopaedics

    Emory University School of Medicine

    Atlanta, Georgia

    Copyright 1998 by The Journal of Bone and Joint Surgery, Incorporated