Handbook of Difficult Diagnosis. - book reviews

Author: Thomas L. Schwenk
Date: Oct, 1991

Common wisdom in family practice is that "it's more important to know the causes of an effect than the effects of a cause." Therefore, most textbooks are organized according to the causes rather than the effects. Handbook of Difficult Diagnosis is a pleasant departure from this format.

The editor has compiled the wisdom of 30 clinicians, mostly internal medicine subspecialists, and organized the information according to 10 traditional subspecialty areas of diagnosis. Within each area, short lists and discussions about the common, uncommon, serious and treatable causes of various signs and symptoms are presented. Each concise chapter is followed by an extensive current bibliography, much of it annotated. For example, in the chapter, "Dizziness and Vertigo: Common and Less Common Causes," 41 causes are listed as peripheral vestibular, central vestibular or miscellaneous in origin, followed by 57 references keyed to the list and 11 additional annotated references to stimulate further reading. In a quick review, the reader can be reminded about labyrinthine disorders, vestibulotoxic drugs and posterior fossa neoplasms, among other causes of dizziness, and be guided to helpful readings about all three causes.

The main limitation of this book is that it covers only internal medicine. A similar approach to pediatric and gynecologic signs and symptoms would be equally helpful (perhaps a good idea for a subsequent project). The emphasis of this book is somewhat skewed to inpatient problems, but the book provides sufficient outpatient orientation involving signs and symptoms (e.g., cough, the solitary pulmonary nodule, flatulence, restless legs, the swollen knee, etc.) to still be extremely useful.

The references in this book are relatively current and the overall format is "reader-friendly." This book can be recommended to family practice residents and practicing physicians as a helpful adjunct to differential diagnosis.


COPYRIGHT 1991 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

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