BOOK REVIEWS Diagnostic Imaging of Child Abuse PK Kteinman 1987, Williams and Wilkins, 297 pages, $55.95

At first glance one might think that this book is more likely to be found in the radiology department; however, the initial chapter reviewing skeletal trauma quickly estab- lishes this book as a candidate for the essential library of every emergency department. The chapter provides an over- view of the mechanism of skeletal trauma, relating patterns of skeletal injury to high, moderate, or low specificity for possible child abuse.

While the book should serve as mandatory reading for any physician who wishes to develop a background in the diagnostic imaging of child abuse, it may readily serve as an on-line reference for the emergency physician confronted with an unusual fracture or radiographic finding. The text is divided into 14 chapters, nine of which are written by the primary author. This provides an even, comprehensive dis- cussion of extremity, bony thoracic, spinal, viseral, and head trauma. An excellent chapter is included on the dating of fractures that may clearly be helpful to a physician called on for expert testimony.

My only criticism is directed toward the superficial clos- ing chapters on "Child Abuse and the Law, .... Psychosocial Considerations," and a review of "Technical Considerations and Dosimetry." The strength of this book lies in its discus- sion of the radiographic presentations of non-accidental trauma in children. This book is both a source of reference and an excellent text for those interested in child abuse.

Rick Miller, MD, FAAP, FACEP Division of Emergency Medicine and

Department of Surgery University of Illinois College of Medicine Peoria, Illinois

John H van de Leuv, MD, CM, FACEP - - Editor Indianapolis, Indiana

Emergency Pediatrics RM t3arkin, P Rosen t986, CV Mosby Company, 735 pages

In the preface to Emergency Pediatrics, by Barkin and Rosen, the editors state that the book "is designed to bring together in an accessible outline format that which is im- mediately required for the care of the acutely ill child by the health care provider .... " The key words in this state- ment are "accessible outline format," and "immediately re- quired."

This 700-page, soft-cover book is organized in an excel- lent manner. The book is essentially divided into two parts. The first looks at traumatic and nontraumatic disorders, discussing them in a traditional order. Following sections on initial assessment and advanced cardiac life support are

those that cover newborn emergencies, emergency com- plaints, and urgent complaints. These are probably the most useful sections of the text.

The editors have neatly and appropriately organized a great deal of information relevant to the day-to-day practice of ambulatory and emergent pediatrics. Within each sec- tion, the authors virtually cover the entire gamut of acute pediatric medical problems in alphabetical order. Emergen- cy complaints range from anaphylaxis and apnea to sudden infant death syndrome and syncope. Urgent complaints cover acute abdominal complaints and child abuse through vaginal bleeding and vomiting.

Each chapter in each section is organized in a similar manner, beginning with the possible etiology and diagnostic findings associated with the particular problem, and culminating in the differential diagnosis and management. Also, many chapters include information relevant to the disposition of the child and instructions to be passed on to the parents. Although the chapters are relatively brief, each offers the pertinent facts that the busy emergency physician needs to know in a pinch, without sacrificing adequate ex- planations. Most chapters are nicely supplemented with il- lustrative tables and diagrams that highlight pertinent facts in boldface type.

Subsequent sections in the first half of the text include environmental emergencies, poisonings, trauma, and orthopedic injuries. The chapters in these sections are organized in a manner similar to those preceding, and are equally succinct and informative. In particular, the section on trauma contains a wealth of practical information, per- haps more than would be expected from a book of this type.

The latter half of this book uses a systems approach to focus on a myriad of diagnostic entities that could poten- tially present to the emergency department or clinic physi- cian. This portion, which includes chapters on both medi- cal and surgical problems, also is presented alphabetically. It begins with cardiovascular and dermatologic disorders, and includes chapters dealing with ENT, ophthalmalogic, gynecologic, and psychiatric disorders. The chapters are pre- sented in a style similar to that of chapters in the first half, beginning with diagnosis and management, and often in- cluding disposition and parental instructions. The chapters are concise and informative, and are more useful for as- sistance with patient management and treatment than as a source of information about the problems themselves.

Overall, Emergerlcy Pediatrics accomplishes what it sets out to do. In a concise outline form, the book provides easy and rapid access to pertinent information that the emergen- cy physician needs to know in a hurry. This makes it an ideal reference for the ED library. The book is by no means meant for leisure reading, nor does it replace standard texts on pediatrics and emergency medicine. These should be re- ferred to for more in-depth and comprehensive information.

Jonathan Maisel, MD Emergency Medicine Residency Bronx Municipal Hospital Center Albert Einstein College of Medicine Bronx, New York

17:4 April 1988 Annals of Emergency Medicine 378/137