BOOK AND MEDIA REVIEWS

according to the educational objectives developed by the author of the chapter. The book would have benefited from
an overview chapter that discussed abuse more broadly, identified commonalities among the types of abuse, and summarized treatment options currently available to abused persons and their families. Last, any text that deals with the
medical treatment of abused or tortured persons should acknowledge and include some discussion of secondary traumatization and the effect that dealing with abuse has on the
health care practitioners themselves.
In summary, Emergency Care of the Abused is an easy-toread reference text about how to recognize and provide immediate medical treatment for different types of abuse. To
our knowledge, it is the first of its kind to address the breadth
of abuse issues that general practitioners, emergency medicine physicians, pediatricians, and others may encounter in
their clinical practice. The intended focus, however, is solely
on acute medical care. In not addressing mental health considerations for either the patient or the practitioner, it does
not alert the practitioner to opportunities for prevention,
early intervention, and short- and long-term treatment options. As such, it does not push clinicians to acquire a deeper
understanding of their role in addressing a complex set of
societal problems.
Melissa L. McCarthy, ScD
Johns Hopkins University School of Medicine
Baltimore, Maryland
mmccarth@jhmi.edu
Karin V. Rhodes, MD, MS
University of Pennsylvania School of Medicine
Philadelphia
karin.rhodes@uphs.upenn.edu
Financial Disclosures: None reported.

ESSENTIALS OF PHYSICAL MEDICINE AND REHABILITATION:

MUSCULOSKELETAL DISORDERS, PAIN, AND REHABILITATION
By Walter R. Frontera, Julie K. Silver, and Thomas D. Rizzo Jr
2nd ed, 935 pp, $119.95
New York, NY, Saunders/Elsevier, 2008
ISBN-13: 978-1-4160-4007-1

WITH MORE THAN 175 CONTRIBUTING AUTHORS FROM A VAriety of specialties, Essentials of Physical Medicine and Rehabilitation is an excellent resource for clinicians interested in sports medicine, pain management, and inpatient
physiatry. The majority of the text is devoted to musculoskeletal syndromes, with the rest divided between pain medicine and rehabilitation. The scope is expansive, covering topics as general as chronic kidney disease and as specific as
corns. It is thorough in its listing and discussion of various
orthopedic and neurologic disorders.
The topics presented, such as osteoarthritis, lumbar degenerative disease, rotator cuff tendinitis, and patellofemo1178

JAMA, March 18, 2009Vol 301, No. 11 (Reprinted)

ral syndrome, are germane to primary care physicians. Because of the books clear and concise language, wellorganized chapters, and illustrative images, it would be a
valuable asset to physicians working in the ambulatory care
arena. The book likewise offers practical advice for common pain syndromes such as arthritis: An occupational
therapy evaluation . . . may identify difficulties with hand
activities (e.g., due to hand [osteoarthritis]) and difficulties with donning and doffing of footwear (due to restricted hip range of motion). Adaptive equipment (e.g.,
reaching devices, sock donners, long-handled shoe horns,
elastic shoelaces) may help maximize independence. . . .
Essentials of Physical Medicine and Rehabilitation would be
equally beneficial to sports medicine clinicians and primary
care practitioners because of the depth and detail with which
it presents each topic. Chapters are devoted specifically to claw
toe, hammer toe, and mallet toe. Certain chapters explain which
radiographic views to order when evaluating different injuries. For example, in a chapter on acromioclavicular injuries,
the author writes that A 15-degree cephalad anteroposterior
view helps diagnose . . . separation between the acromion and
clavicle. . . . The chapter on assessing wounds may be especially useful on the wards. Of note, the authors forego discussing electromyography.
The book skillfully integrates the perspectives of physiatrists as well as orthopedic surgeons on conditions that
they may both address. Compared with its peer textbooks,
this text delves more deeply into surgical treatment options. Multiple chapters discuss operative techniques for various musculoskeletal injuries, the usefulness of different types
of hardware, and potential postoperative complications. The
chapters on flexor and extensor tendon injuries are exceptional and provide descriptions of all the zones of injuries
and their respective management algorithms.
The book is replete with useful and informative figures
and radiological images. Even for rare syndromes such as
Tietze syndrome, the authors provide ultrasonographic
imaging of normal as well as enlarged costochondral joints
to illustrate the foundation for patients pain symptoms. For
office procedures, such as subacromial bursa injections, the
authors illustrate the different directional approaches as well
as the varying success rates with each approach. Excellent
figures and descriptions are used to demonstrate how to perform a wide range of injections, including pronator teres injections and anterior interosseous nerve blocks.
The book clarifies some of the administrative issues surrounding disability. Unlike most textbooks in physical medicine and rehabilitation, it outlines the criteria necessary for
patients to qualify for social security disability based on chronic
pain. In addition, on page 601, the book describes K levels,
which are used by Medicare to determine an individuals functional potential and thus to justify prosthetic components for
patients with lower limb amputations.
Although the text is generally comprehensive, some areas
could be more robust. For example, there are no chapters
2009 American Medical Association. All rights reserved.

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BOOK AND MEDIA REVIEWS

specifically dedicated to the controversies surrounding opioid therapy. In the chapter on postherpetic neuralgia, the
authors write that Studies of corticosteroids, anticonvulsants, opioids, antidepressants, and acupuncture . . . have
not been found to reduce the severity of acute zoster symptoms or the incidence of postherpetic neuralgia. No further information is given about these treatments, which may
lead the reader to the conclusion that these medications are
not useful. However, opioids and tricyclic antidepressants
have often been considered the mainstays of treatment for
both acute zoster and postherpetic neuralgia. Randomized
controlled trials have suggested the efficacy of the anticonvulsants gabapentin and pregabalin,1,2 and both agents have
received approval from the US Food and Drug Administration (2002 and 2004, respectively) for the treatment of postherpetic neuralgia. Also, the organization of the Rehabilitation section could be improved. For example, the chapters
related to traumatic brain injury, spinal cord injury, and rheumatologic disease could have been grouped together.
Despite these minor limitations, the text achieves the difficult goal of satisfying the needs of generalists and specialists alike. Essentials of Physical Medicine and Rehabilitation
is well written and well researched. It would be a valuable
addition to the library of any physician treating sports injuries or chronic pain resulting from musculoskeletal or rheumatologic causes.
Devi E. Nampiaparampil, MD
Division of Pain Medicine
VA Hudson Valley Healthcare System
Castle Point, New York
Muscle and Nerve Pain Specialists, Ltd
Chicago, Illinois
devichechi@hotmail.com
Financial Disclosures: Dr Nampiaparampil reported having served on a research
advisory board for Elan Pharmaceuticals.
1. Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L; Gabapentin Postherpetic Neuralgia Study Group. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA. 1998;280(21):1837-1842.
2. Dworkin RH, Corbin AE, Young JP Jr, et al. Pregabalin for the treatment of postherpetic neuralgia: a randomized placebo-controlled trial. Neurology. 2003;
60(8):1274-1283.

EVIDENCE-BASED DERMATOLOGY
Edited by Hywel Williams, Michael Bigby, Thomas Diepgen,
Andrew Herxheimer, Luigi Naldi, and Berthold Rzany
2nd ed, 723 pp, $300.25
Malden, MA, Blackwell Publishing, 2008
ISBN-13: 978-1-4051-4518-3

THIS HEFTY TOME, NOW IN ITS SECOND EDITION, STARTS WITH

14 chapters on the basis and meaning of evidence-based
medicine and dermatology. These chapters have titles such
as The Field and Its Boundaries, The Rationale for Evidence-based Dermatology, The Cochrane Skin Group,
Critical Appraisal of Pharmacoeconomic Studies, and, most
2009 American Medical Association. All rights reserved.

significantly, How to Critically Appraise a Randomized Controlled Trial. The chapters are clear and well written, with
informative tables and line drawings printed in color. The
text includes many pearls and useful data. References are
pertinent and up to date. Unfortunately, the writing does
have a whiff of defensiveness. As an example, the preface
by Williams starts by saying that Evidence-based dermatology is no longer a dirty word in dermatology. A more
serene approach might have been more desirable.
Chapters 15 to 57 comprise the bulk of the book (approximately 600 pages) and cover a variety of clinical subjects, from
acne to treatment of warts and from basal cell carcinoma to
venous ulcers. A typical heading covers the definition and main
features of the condition (in many cases with demonstrative
clinical photographs); the main questions to be asked and the
answers found in bibliographic searches; and extensive references. Key points are outlined in color in some chapters,
and tables and line drawings are also included. Authors state
when no significant data were found; for instance, There are
no data to support a role for azathioprine in psoriasis (p 180).
We have no qualms with the concept of evidence-based
medicine, or evidence-based dermatology, to be more exact.
The material is based on published data, but this is limiting
in and of itself. A study may have been conducted that would
support one theory or another, but without publication in an
available journal, such evidence would be lost or perhaps ignored. Does this mean that there is no evidence for such a
theory, or does it mean there is no written documentation?
Unfortunately, the quality of the chapters is uneven. This
in part reflects the variability of the available published evidence, but intrinsic variation also exists in the authors work
and choices of clinical topics. First, for example, hand eczema is considered and evaluated as a single item. The clinician cannot really evaluate, say, the role of oral immunosuppressants vs that of corticosteroids, taking together irritant
contact dermatitis, allergic contact dermatitis, and hand dermatitis in atopics as a single subject of therapy. Some rather
unusual and controversial definitions or statements are also
presented; eg, Eczema is, by definition, poorly defined erythema (p 131).
Second, the same problem is also found in the chapter
on leprosy, which states that A biopsy of the skin lesion
may help confirm the diagnosis, improve research, and allow culture of [Mycobacterium] leprae in mouse footpads;
however, the sensitivity is poor, because biopsies can yield
negative results despite obvious clinical signs (p 442). Leaving aside the use of the word may, which should be avoided
in a book on evidence-based practice, the seeming lack of
proper evaluation of the role of biopsies in the diagnosis and
classification of leprosy is a major shortcoming.
Third, the books definition of scabies as an itchy immune hypersensitivity reaction to infestation of skin by the
mite Sarcoptes scabiei (p 463) would exclude crusted scabies or the nonitchy scabies seen sometimes in small children or certain other individuals.
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