Practical Rheumatology is addressed to internists and primary care and general physicians. It is a "direct derivative" of a reference text, Rheumatology, which was designed for specialists and trainees with a particular commitment to musculoskeletal disorders. Rheumatology totalled 1766 pages; Practical Rheumatology totals 432. The content of the latter is suggested by its title: practical, everyday, accurate advice for immediate "use at the bedside." However, its cumbersome size and weight would make it awkward at the bedside and presumably in the office.

Three other books are on the market: Clinical Rheumatology, by Ball and Koopman (WB Saunders, 1986); Clinical Rheumatology: A Problem-Oriented Approach, by Moskowitz (Lea & Febiger, 1975); and Clinical Rheumatology, by Mason and Currey (JB Lippincott, 1970). Practical Rheumatology certainly is up-to-date and clearly addresses the specific clinical problems that generalists, internists, and family physicians encounter. An orderly presentation of anatomic areas in which symptoms and signs occur is found throughout, and all of the usual and common diseases are included. Samples of English usage at intervals of 30 to 40 pages did not turn up poor writing.

Chapter 2, "Signs and Symptoms," is an exceedingly well-done evaluation of musculoskeletal symptoms. It is presented in lean, clean English and is beautifully illustrated—a joy to read. The book is extensively and expensively illustrated (often in color) and includes many useful and practical tables, listings, and clinically effective references. Because of the book's size and weight (13 x 25 cm; 5 lbs), I needed a book rack to use it handily. The paper is of the highest quality—slick and thick. I would vote for less expensive paper and a consequently lower price for future editions.

I searched for some mention of Wolff's Law and related topics—such as the consequences of immobilization in joint and connective tissue structures, the proprioceptive nervous system, stretching, activating functional position sense—and found nothing in the index or the text. These factors are, in my opinion, of great importance in the optimal management of rheumatic diseases, and the price is right for a discussion of these management techniques.

I tested the index by seeking references that interested me and looked for population, viscosity, reversibility, capsule, physiologic, laxity, and hyaluronate. Six of them were listed.

In the balance, the overall quality of the presentation, the practical and clinically useful chapters, the superb illustrations, the effective tables, and the clinical summaries outweigh the defects of this text. Practical Rheumatology is the only recent book on the market that addresses diagnosis, study, and management of musculoskeletal diseases for the designated audience, and I recommend it.