Many of us tend to measure time in units that seem to accelerate as a function of our own aging processes. It is hard to believe that this fourth edition of Fundamentals in Musculoskeletal Imaging by Lynn McKinnis spans 17 years since the first edition was published. At that time we approached this project with some trepidation since we questioned the receptivity of educators, students, and clinicians to the relevance and importance of this content for the armamentarium of health-care providers in general and physical therapists and physical therapy assistants in particular. However, our apprehension has been more than allayed with respect to musculoskeletal pathologies. Inevitably the need to familiarize health-care professional students and clinicians with visualizations of the musculoskeletal system has been prompted by continuous advances in imaging technology. Moreover, educators and clinicians have discovered that imaging can be used as a vehicle to facilitate communication with referring or collaborating physicians and other health professionals or as a conduit for evidence to demonstrate the relationship of intervention to improvement. Such evidence serves to facilitate decisions from third party payers regarding numbers of treatment sessions. The mounting sophistication and clarity with which we understand the pathologies of our patients have emerged from enhanced imaging. This evolution has gained recognition and our past readers have developed an insatiable thirst for more knowledge in the use and understanding of advanced imaging procedures. Undoubtedly, this strong inquiry process has contributed substantially to the emerging popularity of this text. Accordingly, it is not surprising that today most education programs use this text for their students and many practitioners consider it a “fundamental” document for their libraries.
A considerable effort has been undertaken to make this fourth edition even better than the third. Each clinical chapter follows a logical sequence in which basic osteology and connective tissue structures are outlined and labeled. This effort serves as a foundation upon which more sophisticated imaging procedures, including computerized tomography (CT) scans and magnetic resonance imaging (MRI) are added. Specific pathologies with which students and clinicians will then deal follow immediately thereafter. These building blocks are craftily structured so that irrespective of which anatomical region the reader first embarks, their assimilation of the developing content will make comprehension of subsequent chapters easier. As Lynn McKinnis points out so cleverly within her preface when she employs a swimming analogy, the depth and comprehension are progressive. Security acquired in the shallow end will build confidence in deeper waterswhile all the time the instructor is there to coach.
In implementing this process, she has maintained the tradition so much a part of the entire Contemporary Perspectives in Rehabilitation serieschallenging the reader to problem solve while updating relevant references and source materials. This effort is supported through many changes including the addition of approximately 300 new line drawings and images, expanded imaging evaluations for almost all clinical chapters, and conversion of the bound-in student CD to an expanded and enhanced online resource that includes additional questions, an expanded searchable glossary, and, for the first time, a feature permitting the viewer to analyze MRI sequences.
Consumer expectations from the therapists who so dutifully dedicate services continue to rise. As we strive for more respect and participation in decision-making for our patients, there is a growing need for us to understand all aspects of the patient history on the one hand and foster our confidence in conveying our knowledge and impressions to referral sources on the other. One of the most obvious vehicles for achieving success in this endeavor is through communications regarding the meaning of the pictures we and our patients are shown. The growth in information accessibility amongst our consumers and their abilities to use electronic resources to better understand this information has become evident and will only escalate. This emerging sophistication in assimilating information is in its infancy, and our ability to not only anticipate their inquiry but respond confidently and comprehensively has become a presumed expectation. While our learning curve to do so within categories such as genomics, bioengineering, and regenerative rehabilitation continues to grow, perhaps we have reached a point where this responsibility can be achieved in the field of imaging, particularly when musculoskeletal diagnoses are involved. If this premise is correct, then let Fundamentals in Musculoskeletal Imaging serve as our compass.
Steven L. Wolf, pt, phd, fapta, faha
Series Editor, Contemporary Perspectives in Rehabilitation series