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Pediatric Skeletal Scintigraphy with Multimodality Imaging Correlations.
  1. I GORDON, Consultant Radiologist

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    Pediatric Skeletal Scintigraphy with Multimodality Imaging Correlations. By Connolly LP, Treves ST. (Pp 286; hardback £91.50, US$135.00.) Springer-Verlag, 1998. ISBN 0 387 94695 0 .

    The first of five chapters covers the technique and important practical details of radioisotope bone scans, the second covers infection, the third trauma as it affects the skeleton, and chapters 4 and 5 cover benign and malignant conditions of the skeleton.

    The authors and their institution have a high reputation and have been one of the leading proponents of paediatric nuclear medicine. Thus it is no surprise to see a book dedicated to the skeleton in which there are high quality images and the importance of such quality is well demonstrated. The book combines all modalities of imaging and thus allows the reader the opportunity to assess recent advances and know the role of isotope bone scintigraphy in the investigation of a child’s skeleton.

    The chapter headings are well chosen and cover most conditions adequately. Infection is comprehensively covered although one would have liked to see bacteriological proof of the organism stated. The chapter on trauma covers abuse very well and the examples are clear. The possible negative bone scan with a skull fracture deserves more emphasis. Chapter 4 includes not only benign tumours but also a myriad of important conditions where bone scans have an important role to play. These include benign cortical lesions, cystic lesions, fibrous lesions, osteochondroses as it affects all parts of the skeleton, and metabolic bone disease. Again the high quality images do justice to the efforts of the authors and publisher. Each chapter has a useful list of references, which are almost exclusively from the USA

    If the book has any shortcomings these relate to the fact that isotope bone scans are highly sensitive for the detection of skeletal abnormalities but are non-specific and so similar appearances may be seen in different conditions. This is not emphasised and there is little cross referencing to the similarities of images in the different chapters. There are insufficient examples of the changes of the paediatric skeleton with maturation, and there is little emphasis on the importance of knowing and understanding these changes. One of the most difficult aspects of paediatric bone scintigraphy is the identification of the normal bone scan from the abnormal scan, detailed knowledge of maturation is critical tor this.

    This book should be available in every department where isotope bone scans are done, both to ensure that the scan is of diagnostic quality and to have examples of different conditions available.

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