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Getting Started in Clinical Radiology: From Image to Diagnosis

Mallinckrodt Institute of Radiology Washington University School of Medicine St. Louis, MO 63110

By George W. Eastman, Christoph Wald, and Jane Crossin. Stuttgart, Germany: Georg Thieme Verlag, 368 pp., 2006. $49.95 (hard cover) (ISBN: 1588903567)

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The front cover of this basic imaging text for medical students displays an engaging grid of images that includes a cartoon strip of a thoughtful man and cute images of Gummi Bears, as well as CT, sonography, and chest radiography images. In the second chapter the authors describe this book as "...a peek into the soul and life of radiology." And on page 36 is the most amazing photograph of a patient with multiple piercings; in addition, the Foreword, penned by Reginald Greene, refers to the implicit intent of this text to "fascinate students." I feel justified, therefore, in my expectation of a fresh, perhaps unconventional, method of presenting radiology case material. I thought I might have found the radiology teaching equivalent of a reality show—edgy perhaps, but effectively capturing the reader's attention.

"Medicine is an ever-changing science undergoing continual development." Thus begins the Important Note to Reader at the front of this text for medical students. Unfortunately, the approach these authors use— that of creating fictional names and stories to discuss the value of certain classic imaging findings—feels old and unchanging. Fake patient names such as Mrs. Baywatch (to discuss imaging issues of breast implants) and Johnny Drip (to show a case of renal cell carcinoma) recall the teaching style popularized by Ben Felson many years ago. In the authors' words the "...cases are didactically optimized and compressed to fit the objective of this book." The new twist, however, is that the authors created five fictional medical students, using the pictures of real trainees as representative images. The five fictional young imaging gurus are referenced throughout the book as a sort of subtext that might be more effective if it could be carried out online. In fact, I could easily imagine the "e"-edition of this text.

The introductory chapters on basic imaging techniques are very good. In addition, the use of charts at the beginning of chapters to match examination techniques with particular clinical problems is quite effective and is another of the features that sets this text apart from the competition.

As part of my review of this text, I asked a few medical students to take Getting Started in Clinical Radiology: From Image to Diagnosis for a day and let me know what they thought of it. The images were greatly appreciated; students commented that the quality and clarity of the illustrations are very good. Some students, however, noted the "flippant" style in which some cases were discussed. There certainly is a casual tone throughout. I did not find particular support for the informal style in my limited sampling of learners.

The short historical notes placed strategically throughout the text were fascinating to me. One such reference in the chapter on face and neck imaging relates brief vignettes of Robert James Graves of Graves' disease fame, the Irish doctor whose extraordinary life story includes being arrested as a suspected spy in Austria and heroically saving a ship and its crew in the Mediterranean Sea. Many of these historical notes prompted me to search for more information on the Internet. This rediscovery of medical ancestors in a basic radiology text was an unexpected and pleasurable bonus.

This text lags, as texts often do, behind the state of the art in some areas. For example, fluoroscopy is referenced in this text far more often than it is used in current practice. The authors refer to nipple markers used to "reduce the number of fluoroscopies in tumor patients...." However, the quality of our chest radiographs nowadays is such that we rarely need to apply nipple markers. Of course, we use CT to search for nodules when it is important to find them in oncology patients and in other high-risk populations.

Finally, I recommend Getting Started in Clinical Radiology: From Image to Diagnosis to someone looking for a supplement to electronic teaching files and think that it would be useful as a text in a premedical class to provide background information about imaging techniques or simply as an alternate to a basic introductory radiology text.

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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 Anderson, C. Search for Related Content PubMed Articles by Anderson, C. Social Bookmarking                      What's this?