Clinical and Biochemical Disorders of the Skeleton

By Beighton, P

Clinical and biochemical disorders of the skeleton By. R. Smith and P. Wordsworth Pp. 471. Oxford: Oxford University Press, 2005. ISBN: 0-19261-740-0. 125.

More than 50 years ago, Fairbank sparked orthopaedic interest in the heritable disorders of the skeleton. Since then emphasis has been placed upon clinical and radiological delineation, together with elucidation of the biochemical basis of these conditions. However, during the last decade, dramatic advances in cell biology and molecular genetics have resulted in an abundance of information concerning the structure and function of skeletal components. This new knowledge has implications for therapy in the skeletal dysplasias.

In this excellent book, the authors have succeeded in clarifying the complex and potentially bewildering field of the molecular biology of the skeleton. They begin with an account of current concepts of bone physiology and pathology, ranging from histology and bone metabolism to the underlying molecular mechanisms. The next chapter concerns the approach to investigation of bone disorders, and the rest of the book is devoted to specific groups of conditions. They are all here, including osteoporosis, neoplasia, chondroplasias, sclerosing bone dysplasias, fibrous dysplasias and connective tissue disorders. In each instance the classification and pathophysiology is set out, current management is reviewed and relevant references are provided.

It is probable that the book will have two main functions: firstly to provide an up-to-date account of the biological and molecular factors involved in the pathogenesis of disorders of bone and cartilage, and secondly as an accessible source of information concerning individual skeletal conditions. Despite the scientific complexity, the book is very readable; it is not necessary to be a molecular biologist to understand the contents. Although many of the skeletal disorders are rare, collectively they are not uncommon. In addition to orthopaedics, they involve other disciplines, including rheumatology, radiology and paediatrics. This book will be of value to all of these specialties.

The authors are to be congratulated on this magisterial book. The extent of their knowledge is prodigious, and with their clarity of presentation they have produced a masterpiece.

P. Beighton

Copyright British Editorial Society of Bone & Joint Surgery Jan 2006