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RheumatologyA Primary Care Approach. First edition. Bruce M. Rothschild MD. New Yorke Medical Books 1982. 416 pages. Illustrated

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Figure 1. Endometrial biopsy specimen with birefringent perivascular amyloid deposits. (Specimen stained with Congo red, and
photographed in polarized light; original magnification X 285.)
LETTERS
other biopsy, short of a renal biopsy, will further increase
the probability of finding renal amyloidosis at this juncture.
By looking for amyloidosis in all tissues already obtained
from this patient and finding it in an unusual location, we
avoided imposing on her additional discomfort, expense, and
risk of other invasive procedures. Our experience illustrates
the importance of examining previously obtained tissue from
a patient suspected of having amyloidosis, before embarking
on further invasive procedures.
In addition, since blood vessels infiltrated by amyloid are known to be fragile (11, it is possible that the
amyloidosis may have contributed to this patient’s menorrhagia.
Cheung Cho Yue, MD
James H. Lampman, MD
Chan H. Park, MD
Stanley P. Ballou, MD
Case Western Reserve University
Cleveland, OH
1. Cohen AS: Amyloidosis. N Engl J Med 277:522-530, 574-583,
report of the use of endometrial tissue for this purpose. Even
in autopsy studies, the involvement of endometrium by
secondary amylciid has not, to our knowledge, been reported. Our finding of endometrial amyloidosis increases the
likelihood that this patient has renal amyloidosis. Clearly no
BOOK REVIEW
Rheumatology: A Primary Care Approach. First edition.
Bruce M . Rothschild, MD. N e w York, Yorke Medical Books,
1982. 416 pages. Illustrated.
The discipline of rheumatology has made dramatic
advances over the past several decades, but the vast majority of patients with rheumatologic diseases will continue to
be cared for by primary care physicians. Therefore, it is
imperative that primary care practitioners in all medical
disciplines keep abreast of the progress being made in our
understanding of the immunology, diagnosis, and therapy of
rheumatic diseases. Rheumarology: A Primary Care d p proach will assist the primary care practitioner in this
regard, though it will not replace a well-tended article file or
any of the standard rheumatology texts.
Dr. Rothschild’s book is well written and very well
organized. The reproductions of photographs and radiographs are superb in quality, and the text is well supplemented with practical tables and diagrams which nicely complement the content of each chapter. One would not need to
purchase a “highlighting pen” with this book, since there is
absolutely no superfluous information. Virtually the entire
628-638, 1967
2. Glenner GG: Amyloid deposits and amyloidosis: the P-fibrilloses. N Engl J Med 302:1283-1292, 1333-1343, 1980
3. Wright JR, Calkins E, Humphrey RL: Potassium permanganate
reaction in amyloidosis: a histologic method to assist in differentiating forms of this disease. Lab Invest 36:274-281, 1977
discipline of rheumatology is condensed into 416 information-packed pages. (For example, the chapter on rheumatoid
arthritis is only 9 pages long.) Each chapter is followed by a
brief, but current and relatively comprehedsive, bibliography.
Unfortunately, the price one frequently pays for
brevity is superficiality. I believe this is the major limitation
of this text, particularly with respect to therapy of rheumatic
diseases. The review of therapies for specific disorders is not
practical or specific enough to be used in the office of an
active primary care physician.
Despite this shortcoming, this book can be highly
recommended as a brief review of the field of rheumatology.
It should be especially useful for medical students and house
officers who are beginning the study of rheumatic diseases.
It will also be extremely useful for primary care physicians
who are preparing for board examinations. Though it will
have limitations as an office reference, it will enable the
primary care physician to review a remarkable amount of
current information on rheumatic diseases in a brief period
of time.
William A. Norcross, MD
University of California Medical Center
San Diego, C A
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approach, illustrated, bruce, primary, 416, new, page, edition, care, york, 1982, book, rothschild, first, rheumatology, medical
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