T-221. To order a copy of this publication, contact MPA Provider Services at 800-359-2289.
If this truly was meant to be a "pocket book," the genre may have to be redefined. Instant Access to Orthopedic Physical Assessment is just shy of 700 pages, and the bibliography alone is 80 pages. It is difficult to imagine a more comprehensive study of chiropractic orthopedics.
The author wrote this book as a companion guide to the Illustrated Orthopedic Physical Assessment, and the scholarship is impeccable. For example, in the chapter on assessing musculoskeletal disorders, we are treated to the strengths and limitations of nerve conduction velocity (NCV) and electromyograms (EMG). The author describes how NCV tests rule out peripheral nervous conditions, but are not specific to radiculopathy; EMGs show fibrillation potential and denervated muscles, but do not provide information as to the site of injury.
The chapter on cardinal symptoms and signs includes an interesting box that illustrates the differentiation of shoulder tendonitis using pain arcs: abduction means supraspinatus; lateral rotation is infraspinatus; medial rotation is subscapularis; and flexion means the biceps are involved. The chapter on malingering provides more information than you ever wanted to know, and then some - and there are still 10 chapters of regional assessment to explore. These chapters literally cover the body - if not from head to toe, than at least from the neck to the feet.
The book is well-organized, professionally photographed and exhaustively detailed. I particularly enjoyed the clinical pearls inserted in gray boxes throughout the book. Then there are the orthopedic "gamut" sections that present a range of principles relevant in assessing different orthopedic diseases. The author had help writing these sections, giving the book an additional valuable perspective.
The question is, where does this work fit into one's overall library needs? In the world of third-party reimbursement, there are different requirements for communicating the particulars of a case. This work can be used as a dictionary-encyclopedia, allowing the clinician to communicate by referencing the perfect test; sign; maneuver; phenomenon; or law. Hoppenfeld's books are quicker references; Turek's volumes on orthopedics include a surgical perspective; and Cyriax's volumes make for excellent soft tissue algorithms. However, if you could read and study only one publication, Instant Access to Orthopedic Physical Assessment would be it. In fact, all of the abovementioned texts are included in this book's monster bibliography!
It is sad we didn't learn orthopedics from this book when we were all in chiropractic college. Fortunately, it can now be used that way. For its niche, this publication is as good as its gets. It rates a perfect 10 out of 10. It is reminiscent of fine art: When you return to a great painting, you see details that were missed the first time around; the critics may disagree about particularly nuances, but they all agree it is a masterpiece. Maybe Ronald Evans is Renoir, re-incarnated as a chiropractic orthopedist.
If this was the only manual on orthopedics you ever read, but knew it well, you would be an expert on orthopedics, with few peers. Theoretically, you could read this from cover to cover, but its real value is as a reference. In my home, this book sits by our computer. My wife, a physical therapist and certified acupuncturist, leafs through it and shares her findings with me. I would recommend this book to physical therapists, acupuncturists and medical doctors, too - but it's nice to know it was written by "one of us."
Dr. Lavitan's rating:
10 out of 10
If you have authored, published or produced a book, audio or video package that is chiropractic-oriented, educational, nonpromotional and written or produced in a professional manner, and would like it reviewed in Dynamic Chiropractic, please send two copies of the book, video or audiocassette to:
Lynda Bloemke Dynamic Chiropractic P.O. Box 4109 Huntington Beach, California 92605-4109
The proposed merger of the National Board of Chiropractic Examiners and Federation of Chiropractic Licensing Boards was approved by NBCE delegates and FCLB members at their respective annual meetings, held jointly in Atlanta, Ga., this year. Per the new bylaws, the new entity takes the NBCE name, with FCLB continuing as a department within NBCE. The federation will continue to enjoy Board of Directors representation on what will be a single, expanded board.
Before introducing subscapularis syndrome as an upper extremity analog, it is essential to revisit piriformis syndrome as a well-established example of myogenic pseudo-radiculopathy. Piriformis syndrome has long served as a clinical exception to disc-centric models of lower extremity pain and provides an important framework for understanding how deep muscular dysfunction can mimic radiculopathy in the absence of nerve root compression.
Pain has become the dominant language of musculoskeletal healthcare. Numeric pain-rating scales and symptom reports are routinely used as primary indicators of clinical success. But while pain reduction is meaningful, it is an incomplete and often misleading representation of recovery. This has real consequences for patient adherence, long-term outcomes, and how conservative care is perceived within the broader healthcare system.
