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Radiology of bone diseases. Second Edition. By George B. Greenfield. M. D. Philadelphia. J. B. Lippincott. 1975. 667 Pages. 1139 Illustrations. Price50.00

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RADIOLOGY OF BONE DISEASES. Second Edition. By George B. Greenfield, M.D.
Philadelphia, J .B. Lippincott, 1975. 667 Pages,
1139 Illustrations. Price: $50.00.
As a practicing orthopedic and bone radiologist,
I have been asked to review this text from the standpoint
of its value to the internist and the rheumatologist. For
those individuals, and for any student or practitioner
who deals with roentgenograms of patients with bone
disease, this is indeed a most worthwhile text.
In the 5-year interval since the first edition, the
author has, as indicated in the Preface, attempted to
devote more space to the metabolic aspects of bone
disease, and has included an important chapter on the
arthritides.
The clinician should not anticipate a great deal of
information related to the clinical aspect of these diseases, but certainly the radiologic aspects are extensively
described. Moreover the approach of the author should
be of particular interest to virtually anyone dealing with
the roentgenology of bone diseases.
The text is extensively illustrated with high-quality reproductions. There are numerous tables of differential diagnoses. One of the important aspects of this book
is the review of the pertinent radiologic literature. This
review is extensive, containing more than 1100 entries,
and is extraordinarily up-to-date for a textbook. Moreover the index is comprehensive and allows easy reference to any area in the text.
In summary Dr. Greenfield’s text is a valuable
addition to the library of any internist or rheumatologist
who works with roentgenograms of patients with bone
or joint diseases. It is even more valuable than that: It
forms an important place in the library of the roentgenologist dealing with these diseases.
JEREMYJ . KAYE,M.D.
Hospital for Special Surgery
New York. New York 10021
NORMAL AND OSTEOARTHRITIC ARTICULAR CARTILAGE, Proceedings of the
Symposium. Edited by S. Y. Ali, M . W . Elves,
and D . H . Leaback. 319 Pages, Illustrated.
1975. Price: $1 2.50.
For copies write to The Secretary, Experimental Pathology Unit, Institute of Orthopaedics. Stanmore, Middlesex, H A 7 4 L P , England.
The symposium on “Normal and Osteoarthritic
Articular Cartilage” held at the Institute of Orthopaedics, Middlesex, England, was designed to further the
exchange of information on osteoarthritis and to in-
tegrate this information within various subspecialties of
a very specialized field of research. The publication of
these proceedings substantially achieves this goal. Although much of the data contained in this publication
had been presented elsewhere, it is apparent that much
more license had been given the participants at this
symposium in their interpretation of experimental evidence. This climate resulted in some rather free-flow
thinking and the not so surprising outcome was a very
stimulating effect on the exchange of ideas. In this manner possible new avenues of approach in research on
osteoarthritis were examined and critically evaluated.
Of particular interest in these proceedings was
the emphasis placed on the existence of territorial differences in cartilage with respect to matrix composition
and chondrocyte biochemistry. The concept of articular
cartilage as a homogeneous mass with a sparce population of similar cells does not now appear tenable as an
accurate model of this tissue. Suggestive evidence related the focal nature of osteoarthritic lesions to territorial differences within the cartilage in that an unknown
environmental trauma probably induces genetically predisposed alterations in chondrocyte biochemistry resulting in lysosomal enzyme-mediated degradation of the
matrix. Dissolution of the matrix in turn stimulates further production of proteoglycan resulting in a cycle of
repair and degradation. This idiopathic inference of the
pathogenesis of osteoarthritis appears to conflict with an
alternate suggestion that structural changes of joints are
primarily responsible for modifications of biochemical
parameters in the chondrocytes. In this case there is no
presumption of osteoarthritis as an idiopathic disease.
Although resolution of these two concepts awaits further research developments, it becomes apparent as one
reads through these proceedings that the chondrocyte is
the ultimate effector of matrix change, and therefore of
joint function. As such the chondrocyte is becoming the
target for active investigation. In particular the dynamic
balance between anabolic and catabolic phases of metabolism of the chondrocyte has directed research toward
studies of the factors that control homeostasis in the
tissue.
Excellent review articles-especially by Bentley
on experimental osteoarthritis, Sokoloff on osteoarthritis, Mankin on biochemical characteristics of
osteoarthritis, and Elves on transplantation of osteoarthritic tissue-are particularly informative. These
proceedings are suitable and indeed strongly recommended readings for active investigators in connective
tissue research, rheumatologists, and students of pathologic physiology.
LOUISLIPPIELLO,
PH.D.
Massachusetts General Hospital
Boston, Massachusetts 021 14
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radiology, second, greenfield, georg, disease, page, philadelphia, bones, price50, edition, 1139, 1975, 667, lippincott, illustration
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