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Doody's Review ServiceReviewer: Tamara j Vokes, MD (University of Chicago Medical Center)
Description: This manual is intended to be a quick and easy reference for practical handling of both simple and unusual clinical disorders of bone and mineral metabolism. There is very little background material; instead the focus is on practical aspects of clinical presentation, differential diagnosis, laboratory and radiological evaluation, and treatment approach.
Purpose: This book is intended for use in patient care, where a busy clinician is often unable to search through larger textbooks or original reports. The main aspects of various diseases and their treatments are presented concisely, often given as an outline, rather than detailed description. Since the field of bone and mineral metabolism has been changing and developing rapidly, it is difficult for many clinicians who see patients with these disorders only occasionally to keep up with the newest advances in the field. Therefore, it is useful to have this easy to read source where new data are critically evaluated and presented in a practically applicable format.
Audience: Although intended for primary care physicians, this book is also useful to the busy specialist for whom this field is not the primary area of specialty focus (internists, endocrinologists, orthopedists, etc.). It would also be of value to medical students and residents, particularly when they are presented with acute clinical situations where timely initiation of appropriate diagnostic and therapeutic action is of importance. It is useful to readers who have at least some understanding of the subject, but not as primary instructional material for those who are not familiar with pathophysiology and basic clinical information. The contributors are experts in their respective fields and present clear, practical guidelines even for controversial areas.
Features: Clinical problems seen in all ages are addressed — from infant to geriatric patient. Rare problems are discussed (inherited diseases, juvenile osteoporosis, and disorders associated with high bone mass), and common disorders are covered in more detail (osteoporosis, osteomalacia). The indications and utility of various diagnostic procedures are reviewed, including bone biopsy. The section on use of bone markers is particularly good because an important but controversial subject is clarified. In contrast, the chapter on pharmacological therapy of osteoporosis has a good listing of different agents but lacks a critical comparison of different therapies. Such a discussion might help a reader in a dilemma commonly encountered in clinical practice: deciding which of several currently available agents would be best suited for a given patient.
Assessment: This is a welcome addition to the quick and easy reference material for a busy clinician. It is particularly useful as the editors cover the newest advances in this rapidly changing field, and they also give an authoritative overview of less common diseases. For a more detailed review of the same topics the reader is referred to Favus' Primer on the Metabolic Bone Disease and Disorders of Mineral Metabolism published by the American Society for Bone and Mineral Research.