Book Review

Title:	Systematic Musculoskeletal Examination Including Manual Medicine Diagnostic Techniques
Author:	Herbert Frisch, MD
Publisher:	Springer-Verlag
Publication:	Hardcover, 451 pages
Category:	Doctor and Student Education
Price:	$137

This book is an interesting combination. It has elements of orthopedic exam, neurologic exam, motion palpation, and x-ray analysis. In short it would appear to be the kind of book written by a chiropractor, but it wasn't. The book was authored by a German medical physician. Dr. Frisch is chairman of the Physician's Seminar of the German Society of Manual Medicine, in Hamm, Germany. Dr. Frisch has endeavored to incorporate the components mentioned above into a systematic musculoskeletal examination, combining precision with shorter examination times.

Dr. Frisch has produced a well-organized text incorporating the more traditional examination techniques with those unique to manual medicine. He uses the traditional organization of body part/region and the familiar standing, seated, supine, and prone examination positions. The author does incorporate into the examination those procedures more familiar to members of the chiropractic profession, such as palpation and motion palpation. He outlines patterns for the palpation exam to ensure a complete and thorough examination. Another procedure outlined is the evaluation of functional leg length evaluation. In the chapter on examination of the lumbar, pelvis and hips, Dr. Frisch outlines the use of leg length evaluation to differentiate hip from SI, from lumbar spine, from muscle origin, both in supine and prone positions. Each aspect of examination also includes the normal findings one would expect. This would be particularly helpful to students with little to no clinical experience.

Throughout the text, Dr. Frisch uses what he terms the "5/5 scheme." Each aspect of the examination inspection, palpation, motion testing, neurologic, and angiologic tests is broken down into five subgroups, providing a very systematic approach that is logical and easy to follow. For example, inspection is broken down into: gait; posture; contours; skin; orthopedic aids; and palpation into skin; muscles/tendons; tendon sheaths; joints/nerves; and vessels. The "5/5 scheme" is followed throughout the text.

The chapter on radiologic evaluation was particularly interesting. I have seen very few texts where the biomechanical aspect of x-ray evaluation is as thoroughly covered. The author demonstrates the use of line drawing analysis to evaluate spinal function which mirrors many of the various chiropractic techniques, but also includes some not previously seen.

The text is well illustrated. There are photographs of the examination procedures with indicators of direction and placement, as well as diagrams and drawings of the various parts and tissues being examined. The only drawback is all illustrations and photographs are in black and white. The addition of color in some of these illustrations would have helped to bring out the author's point.

Overall this is a very good book. It would provide an excellent review and reinforcement for the practitioner, and serve very well as a textbook for students being introduced to the subject of neuromusculoskeletal examination.

Dr. Stephen Savoie rating: 9 out of 10