Dynamic Chiropractic - September 1, 1992, Volume 10, Issue 18

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The Musculoskeletal System -- Differential Diagnosis from Symptoms and Physical Signs

Category: Patient Care

Author: John McM. Mennell, M.D.

Publication: 191 pages -- hardcover

See pages xx, Part #T-143 for information on how to order

Here is a book that is straightforward and to the point from the very beginning. There is no fluff. If you want to know the bottom line of diagnosing the muscles, bones, cartilages, joint capsules, tendons, and bursa, this is the book for you.

Dr. Mennell begins with the structures of the musculoskeletal system. He is very specific in covering symptoms and structures. Chapter 3, "After Structural Diagnosis" is a well-organized presentation of diagnostic clues that can lead to an accurate diagnosis. Later chapters cover the clinical examination and Dr. Mennell explains the subtleties of exam findings in very specific and understandable terms.

Chapter 6 covers "Intricacies and Interrelationships in the Body Systems." This chapter alone is worth the price of the book. It is a "big picture" type explanation of trigger points and pain assessment of injuries. It specifically covers coccyx pain, forward head syndrome, chest wall pain, abdominal wall pain, TMJ, and stress and tension control. Reading the book is like spending a week with a world expert on diagnosing musculoskeletal pain and picking his brain.

The book has value for the new and very experienced practitioner. It can be frustrating when a patient is not responding to our care. That is precisely when we need to rediagnose the problem. Either we have missed something or a different treatment might help more. Dr. Mennell has described a logical thought process to arrive at a proper assessment of a patient's complaint.

Dr. Mennell is a clinical professor at the College of Osteopathic Medicine at Michigan State University. He has 38 years experience in musculoskeletal diagnosis. He has published dozens of research papers over the years and is a longtime personal friend of Dr. Janet Travell, the well-known pioneer of trigger point therapy. His experiences dealing with the "mechanical" rather than allopathic aspects of musculoskeletal pain are invaluable to chiropractic doctors.

The book is well written, with many photographs, illustrations, and x-rays to demonstrate and enhance what the text explains. If doctors follow the logical examination procedures, it is unlikely they will fail to diagnose a problem. This addresses issues of liability and malpractice, and should make the doctor less vulnerable to both.

The value of the book is high relative to the cost. Do not, however, expect a Merck Manual or some 1,500 page tome. Expect a cogent, concise, easy-to-follow method of approaching a patient with pain.

Rating: 8 on a scale of 10

Steven Eggleston, D.C.
Huntington Beach, California