Description: This is basically a handbook that presents technical cues for performing a number of injections into most areas of the body. The author includes chapters on risk and benefits, advanced techniques, and touches on medicolegal issues. The table of contents becomes an easy reference to identify the target anatomy. Simply turn to the page and there is a picture and sequence describing the technique.
Purpose: The purpose is to describe specifics and advance the skills of practitioners using injections to treat patients with musculoskeletal pain. Although these goals are worthy, I am concerned that the author fails to reiterate the risks of specific injections as they describe each specific anatomic site. It is possible that general practitioners and physical therapists for which this book is intended will simply turn to the page of appropriate anatomy and skip the separate, brief chapter on risks and concerns of injections. Because of this, I am reluctant to say that the author has safely achieved her goals.
Audience: The target audience includes both physical therapists and general practitioners. It is under-written for those practitioners who already use injections liberally and a reasonable reference for those who rarely use them. Medical students might find the pictures and simplicity of presentation of value, but caution should be emphasized because the format minimizes likelihood of potential problems (especially in specific areas.)
Features: This manual begins with a nice overview of the drugs available, preparation protocol, and reviews the potential risks, benefits, and alternatives to standard steroid injections. The author then sequentially walks through the anatomy, including two-color pictures and descriptions for injections into each anatomic location. The book's advantage is its simplicity and ease of use. A number of shortcomings limit the application of this manual, however. My biggest concern is that the author fails to reiterate potential complications with each specific injection site (e.g. MCL rupture with injection of golfer's elbow).The spiral binding inside of a normal binding will not prove durable over a long period. The two-color pictures are distracting and should be full color. Some techniques are poorly pictured and, indeed, show placement of the needle in the wrong site (tennis elbow), and one picture was inverted (coronary ligament of the knee).
Assessment: I was excited to review this offering on techniques of injection but was disappointed by the ultimate production. The authors downplay the risk of complications such as ligament weakening and rupture. A more up-to date offering might elaborate on the current thinking and techniques of prolotherapy, which was mentioned relatively briefly. Much of the content is of value, but safety has to be emphasized with a thorough discussion of the risks and benefits of these techniques. The book needs to include the viewpoint of the person that takes care of the complications of the injections. I would not recommend this manual in the current form to my students or residents.