In February 2009, the American Physical Therapy Association, based upon a mandate from its House of Delegates, sponsored the Physical Therapy and Society Summit (PASS) to determine the extent to which its objectives to achieve “Vision 2020” were on target. Feedback about this directive were gathered from stakeholders and multiple private and public agencies. Among the very constructive input provided by the collection of reviewers was the observation that several activities and experiences might not be met in the absence of acquired content in emerging fields of science, technology and discovery. Not surprisingly, one area identified as deficient in its scope and integration into education was the role of imaging as an information base for decision making and treatment assessment within the physical therapy community. This concern serves as a reaffirmation of the work undertaken by Lynn McKinnis, who had produced the first edition of Fundamentals of Musculoskeletal Imaging in 1997, 12 years prior to the PASS meeting! In this regard, Lynn was ahead of her time. The fact that the text is now in its 5th edition not only serves as a validation of the observation made by the PASS faculty, but to the progressive interest in imaging, which is now clearly entrenched within orthopedic, sports medicine, pediatric and geriatric rehabilitative care.
Lynn has updated all references and has maintained a perspective that benefits students and clinicians alike. Chapters and their respective content build upon fundamentals of radiology and subsequently, imaging techniques and the evaluation of specific anatomical components and their pathologies. Each chapter ends with a summary of key points, a self-test, and where appropriate, case studies. There ae 34 new images and drawings in the text. The reader should be particularly drawn to Chapter 18 that most importantly speaks to integrating imaging into clinical practice. The focus in this chapter underscores the philosophy of the text, to empower the clinician to best understand musculoskeletal pathologies as we strive towards best serving our consumers.
Whether used as a primary learning tool, a reference text, or, hopefully both, absorbing the content in this text will enhance our communication skills within physical therapy and across disciplines. Within the past decade, the nature of the inquiry process regarding patient treatment within the clinic or via consultations has undergone a profound transformation. I have witnessed precision in the communications amongst those discussing a patient plan. Often the basis for such discussions revolves around such questions as “What was the extent of the fracture?”, “How well has the site healed?”, “How extensive is the joint arthritis?”, “Is there evidence of osteoporosis?”, “Has the disc protrusion resolved?”, or “Did the ultrasound reveal a tear in the tendon?” All these queries share one common thread…they presume that the response is based upon imaging analyses from which treatment decisions can be rendered. So often these questions are generated by rehab clinicians, often physical therapists. Independent discussions with several therapists, affirmed my impression that those asking the questions were well-versed in comprehending knowledge derived from one or more imaging approach. On several occasions, I asked how these clinicians acquired their acumen in comprehending the answers to these questions and how the information generated treatment decisions. Remarkably, the responses were uniform. They were based upon excellent classroom and clinical training and the use of Fundamentals of Musculoskeletal Imaging as the “go to” reference because that resource was their text as they studied musculoskeletal injuries and repair. These observations serve as a testimony to the impact that McKinnis and her contributors have had upon past students and many clinicians.
Indeed, this train has left the station…its engine is more powerful and its speed swifter. Undoubtedly, the content will continue to grow as the technologies expand. We are along for the ride, and many are waiting to board!
STEVEN L. WOLF, PT, PhD, FAPTA, FAHA, FASNR
Series Editor, Contemporary Perspectives in Rehabilitation series