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Imaging of the Chest: A Teaching File FREE TO VIEW

David S. Mendelson
Chest. 2004;125(2):803. doi:10.1378/chest.125.2.803
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By Patricia J. Mergo. Philadelphia, PA: Lippincott Williams & Wilkins, 2002; 271 pp; $95

There are several means of communicating the visual aspects of radiology to the clinician. While many texts integrate radiologic findings within the traditional didactic text, another approach is to make the radiologic findings of primary importance and secondarily reference the more traditional didactic material. It is this latter approach that Imaging of the Chest: A Teaching File utilizes. The success of this approach and the value of this volume to any given reader will very much depend on the starting knowledge base of that individual.

The book is intelligently organized around radiographic patterns of pulmonary disease. Within each chapter there are several cases, usually described in succinct 2-page presentations, starting with a straightforward clinical history and a set of figures. The radiologic findings are then described, followed by a brief differential diagnosis, the correct diagnosis, and lastly a terse discussion. There are a total of 150 case presentations. Chapters presenting mediastinal abnormalities and pleural disease are included, as well as those dealing with pulmonary disease.

The figures are of good quality. As one would expect in a volume on pulmonary diseases, chest radiographs and CT scans dominate. The findings are always easy to appreciate on the CTs; the chest radiographs, which are usually more difficult to reproduce, are generally of reasonable quality. The greatest strength of this book lies in its organization, which consists of an intelligent grouping of radiologic patterns. Hence, in many ways it is a textbook of differential diagnosis that presents diseases with overlapping radiologic patterns and offers “pearls” with regard to how to distinguish among them. This approach emphasizes how best to order one’s differential diagnoses and is the most important attribute of this volume.

While offering some of the traditional didactic information in the course of the discussions, these remain simple overviews. In fact, this is very much at the level one might expect in making radiology rounds: an offering of common clinical wisdom that is associated with the radiologic findings. Consequently, this work is not truly intended to be an authoritative textbook of pulmonary disease; for that, one must go elsewhere. Sporadically throughout the book, the author includes a box of “Key Imaging Findings” pertaining to a specific diagnosis; however, this is offered rarely and randomly. At the end of each chapter is a list of suggested reading, related to the patterns described in the cases of that chapter. These are not attached to any particular disease and seem to be of limited value to the clinician searching for specific information with regard to an item that has piqued his or her interest while reviewing a case.

In summary, for the right audience—a resident, medical student, or more experienced physician who would like a quick means of learning radiologic patterns—this book effectively provides such a tool. It might also be of value to a more experienced clinician, who is somewhat less comfortable with CTs and would like to quickly develop some familiarity with the appearance of disease with this modality. It is not a teaching file of clinical and pathologic information, but rather remains true to its title: a teaching file of “imaging.”




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