Book Review

The Measurement of Metabolic Bone Disease

N Engl J Med 1996; 334:805-806March 21, 1996

Article

The Measurement of Metabolic Bone Disease
(Measurements in Medicine Series. Vol. 1.) Edited by F.I. Tovey and T.C.B. Stamp. 152 pp., illustrated. New York, parthenon, 1995. $58. ISBN: 1-85070-465-1

This multiauthored British textbook is the first in a series that will review techniques of quantitative measurement in medicine. The quality of the printing, binding, black-and-white photos, and line drawings is very good. The book includes a single color plate showing the histology of several disorders. The majority of chapters describe currently used techniques of bone measurement, including biochemical markers of bone turnover, bone histomorphometry, radiographic morphometry, and photodensitometry. These chapters are generally well written, concise, and current. There is some redundancy between the chapters entitled “Radiographic Morphometry and Photodensitometry” and “Quantitative Measurements in Osteoporosis.” I am surprised that there is not a separate chapter on absorptiometry (single-photon, dual-photon, and dual-energy x-ray techniques), since these methods have become the most widely used and popular screening techniques for identifying and following metabolic bone diseases, especially osteoporosis, in the United States and Western Europe.

Several chapters review normal bone anatomy, normal physiology, and the clinical aspects of metabolic bone disease. They are very brief and spotty. The diagnosis, pathophysiology, and treatment of metabolic bone disease are covered in less than five pages. Several disorders, such as renal osteodystrophy, are not discussed at all. This criticism may be unfair, since the book is not intended to be a general textbook of metabolic bone disease. Nonetheless, most clinicians, internists, endocrinologists, and nephrologists who wish to add a textbook of metabolic bone disease to their libraries might be better served by a more general one. The pathophysiology, pathology, diagnosis, and treatment of bone disorders are discussed in much greater detail in general textbooks, which also review many of the measurement techniques addressed in this book. The Measurement of Metabolic Bone Disease is probably best suited to experts in the field of bone disease who desire a relatively brief and current review of quantitative bone-measuring techniques.

Michael Emmett, M.D.
Baylor University Medical Center, Dallas, TX 75246