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Primer of Diagnostic Imaging

New Jersey Medical School, Newark, NJ 07103

3rd edition. By Ralph Weissleder, Jack Wittenberg, and Mukesh G. Harisinghani. Philadelphia: Mosby, 1049 pp., 2003. $169

If you would like to review books for AJR, please send a cover letter stating your interest with a current curriculum vitae to Assistant Editor for Book Reviews, AJR, 101 S. Stratford Rd., Ste. 303, Winston-Salem, NC 27104.

In our neck of the woods, in addition to the return of the robin, we have other sure signs of spring. The most eye-catching is the appearance in house staff lockers, at didactic conferences, and at the PACS screen of a bright red and purple object. It is not a crocus but the third edition of the Primer of Diagnostic Imaging by Weissleder, Wittenberg, and Harisinghani. The emergence of this book is a reliable harbinger of the oral board preparation season.

Its colorful exterior aside, there are other reasons this book is hard to miss. The book weighs 5 lb (2 kg) by my scale, extends 9.5 inches (24 cm) from top to bottom, and contains 1049 pages. Its heft places it at the upper limit for portability. And yet it appears to have found nearly universal favor with residents of my acquaintance.

Good reasons abound for its widespread popularity. The book is chock-full of information in outline form, encompassing much of the core knowledge in radiology. The mix of blank space and writing is attractively arrayed on the page, supplemented by excellent anatomic drawings (but no radiographs) and differential diagnoses that, for the most part, are succinct and apt. The difficulties in organizing material of so diverse a nature are largely overcome by placing the same fact in a number of contexts, which reinforces retention of its relevance.

The book is organized in 14 chapters, divided primarily by organ systems, with separate headings for pediatric radiology, nuclear imaging, contrast agents, and imaging physics. The sparse references listed at the end of each chapter are limited mainly to general texts in each region of interest, rather than to focused monographs or new landmark articles. For example, of the eight suggested readings at the end of the cardiac chapter, only two were published after 1995. Given the length of time it takes to get such tomes to press, the reader of Primer of Diagnostic Imaging must be aware that the information presented may not include many recent observations and insights.

I am pleased that one page is devoted to a schema outlining the appropriate form of a diagnostic radiology report. In no other "prep" book have I ever seen attention given to this important component of a radiologist's duties.

On the other hand, after the table of contents and before the first chapter is a five-page glossary of abbreviations. In this era of heightened awareness about medical errors, we have come to realize that abbreviations do much to hinder communication, create ambiguity, and introduce uncertainty; thus, abbreviations increase the possibility of clinical mistakes. Hence, efforts should be made to restrict the diffusion of acronyms and initials into common parlance as replacements for actual terms. This book uses abbreviations liberally, even in the substance of the text. For example, on page 185, the table listing radiographic patterns of gastrointestinal infections and infestations is replete with abbreviations, with their explanations provided just beneath the table. It would be better to write everything out. Moreover, it would be better to place the abbreviation list at the end of the book.

A few other quibbles: Some important areas are excluded. I could find no discussion of pneumoperitoneum, a diagnosis a radiologist must be prepared to make even when it is not considered by referring physicians. I came upon some differential diagnoses that are too long and therefore unhelpful, if not misleading. The most glaring example is the laundry list of the many causes of peritoneal calcifications, some of which are not actually in the peritoneal cavity. The text could also benefit from more careful editing. Spelling errors are not rare. For instance, on one page, the capitalized heading is "zyogomycoses" and just below it, the operational word is "zygomycoses."

Yet, all in all, the encapsulated lists and cryptic comments serve a useful purpose for the junior radiologist who has been exposed to the principles and content of radiologic interpretation earlier in training and needs a refresher. As the authors state in their preface, their book, like any review, is no substitute for first-time learning or in-depth understanding. The third edition of the Primer of Diagnostic Imaging deserves its niche in a resident's library for reference at any time of the year.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baker, S. R. Search for Related Content PubMed Articles by Baker, S. R. Social Bookmarking                      What's this?