Peter Bullough: Orthopaedic Pathology, 4th edn, 560pp, Edinburgh, Mosby, 2004 ($199).

The well known dogma of orthopedic pathology, inculcated into our minds during the sophomore year of medical school, and repeated on many occasions thereafter, states that orthopedic tumors should always be diagnosed by correlating the gross and microscopic findings with the clinical and radiological data. Other bone diseases do not necessarily require such a tripartite approach, but pathologic diagnoses of even these entities are always more meaningful to clinicians if formulated in consultation with other specialists. From these premises it follows, that a good textbook of orthopedic pathology must de Rigueur be iconocentric, and include as many relevant data as possible, illustrating the clinical, radiological and pathologic aspects of bone disease.

To make a first class textbook of orthopedic pathology it is however not enough the follow the dogma. One must take all the data pull them together and present in an understandable manner. This feat can be accomplished only exceptionally and by an exceptional person, like the authors of the present text. A first class pedagogue, a skillful writer and stylist, Dr Peter Bullough has been professor of pathology at Cornell in New York for more than 30 years. During that time he has been honing his diagnostic skills in orthopedic pathology and discussing bone pathology with clinicians and other colleagues. At the same time he has rewritten his book four times since 1984, when it appeared for the first time in print. By now he has brought it almost to perfection. It is hard to imagine that it could be done better in such a condensed form.

True to the dogma mentioned above, all bone diseases discussed in this book have been illustrated by combining the input of surgeons, radiologists and pathologists, as well an assorted group of other clinicians who contributed whenever necessary. The end result is a coffee-table size book full of incredibly nice illustrations. On occasion it is not possible to say whether this is due to the fact that the bones are so photogenic, or because the author has such a fine sense for photography. For those not familiar with histopathology or gross pathology there are numerous camera lucida line drawings (tracings) pointing out the essential features of complex pathologic specimens. These should be welcome by novice pathologists, but even more by surgeons and radiologists.

This book covers both the neoplastic and nonneoplastic bone diseases. In addition to being an atlas of radiologic, macroscopic and microscopic pathology, it could also serve as a succinct textbook. It is very manageable, not too long, not too short, chuck-full of well chosen facts, readable. The text is informative and amplifies the message contained in the photographs. I also admired it because it is so down to earth, non-pretentious, and wise. Well-chosen diagrams and schematic drawings, which help understand the basic concepts, are yet an another attraction. The references are well chosen and reasonably current.

In my opinion this book deserves to be on the essential reading list for all pathologists radiologists and orthopedic surgeons in training, but it is also recommended to all practicing clinicians dealing with bone diseases.