Book Review

Ultrasound in Emergency Medicine

N Engl J Med 1996; 334:1676-1677June 20, 1996

Article

Ultrasound in Emergency Medicine
By Michael Heller and Dietrich Jehle. 236 pp., illustrated. Philadelphia, W.B. Saunders, 1995. $50. ISBN: 0-7216-4506-2

Ultrasonography has an increasing role as a bedside method in the daily clinical work of physicians. Technical improvements and the affordability of diagnostic ultrasound equipment make it ideal for emergency medicine. Because emergency medicine is at the intersection of many medical disciplines, Michael Heller and Dietrich Jehle give us an overview of the applications of ultrasonography in different fields.

The first chapter briefly introduces the technique of ultrasonography and the acoustic phenomena displayed in ultrasound images. In less than 40 pages, with the help of many illustrations, the authors explain the fundamentals of the clinical use of ultrasound. The book then discusses primary and secondary applications of ultrasonography in routine and special procedures, respectively. This division of the book into two parts gives the reader rapid access to the sections of text corresponding to clinical questions at hand.

The book covers mainly cardiovascular, abdominal, obstetrical, and gynecologic applications. Not enough cases of the use of ultrasound in patients with trauma are presented. The treatment of this topic, in comparison to the others, is too short. Furthermore, discussions of important applications, such as ultrasonography of the joints, are missing. I do not agree with the authors' classification of appendicitis as a secondary application of ultrasonography; sonography should be a routine procedure when appendicitis is suspected, because of the high sensitivity and specificity of the technique. An important limitation of this book is that it only shows gray-scale images. A book about emergency ultrasonography should include color Doppler measurements, which are common in daily practice. In general, most of the illustrations are of high quality and represent the state of the art, except those in the section on cardiac ultrasonography. Unfortunately, the cardiac images are of poor quality.

The information on the techniques of examination, as well as the presentation of many ultrasound images, make this book an invaluable guide to practical applications. The book would be appropriate for surgeons and gynecologists and can also serve physicians who want to learn how to perform emergency ultrasonography.

Ulf K.M. Teichgräber
Hannover Medical School, 30623 Hannover, Germany