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Musculoskeletal injection skills
  1. Z Foster,
  2. T L Schwenk
  1. Department of Family Medicine, University of Michigan, L2003 Womens, Box 0239, Ann Arbor, MI 48109, USA; tschwenkumich.edu

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    Monica Kesson, Elaine Atkins, Ian Davies. London: Butterworth-Heinemann, 2003, £24.99, pp 194, softcover. ISBN 0750643722

    Musculoskeletal injection skills was written primarily by British physiotherapists for a graduate educational programme or physiotherapists who perform soft tissue therapeutic injections. The secondary audience for this book, according to the authors, is general practitioners. As is true for all books, this one has difficulty being all things to all readers.

    At first glance, the book is very appealing. Colourful photographs demonstrate positioning and injection sites for dozens of soft tissue, tendon, and bursa injections, accompanied by sketches of the underlying anatomy and needle trajectory. There are frequent clinical tips and “pearls” as well as detailed lists of equipment required.

    These advantageous features, however, are exactly what make this book less valuable for the doctor with significant experience with musculoskeletal injections. The first four chapters cover very basic information, such as basic pharmacology, needle sizes and colours, and no touch sterile procedure, which is probably useful for physiotherapists but not for experienced doctors.

    On the other hand, there are injections described, such as the hip joint (intra-articular) or the iliopsoas bursa, which are unlikely to be performed by primary care doctors, or by most sports physicians for that matter, without radiological guidance. Other injections are for conditions for which there is controversy (at best) about the injection’s value, such as lateral epicondylitis, but the book merely hints at the lack of data and does not fully address the issue.

    Although the production value of the book is high, it is difficult to recommend it wholeheartedly to any group. It is somewhat helpful for family and general doctors, although it is probably both too basic and too complex at the same time. It might be a useful introductory text for doctors training in sports medicine, but would lose its value as the practitioner’s experience increased.

    Presentation20/20
    Comprehensiveness15/20
    Readability19/20
    Relevance11/20
    Evidence basis11/20
    Total76/100

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