Squire’s Fundamentals of Radiology

American Journal of Neuroradiology

Robert Novelline. 6th ed. Cambridge, MA: Harvard University Press; 2004. 638 pages, 20 color illustrations. $85.00.

The sixth edition of Squire’s Fundamentals of Radiology continues to serve as a landmark publication of the teaching of basic radiology to medical students, house staff on clinical services, and for those in their first months of radiology training. This 2004 edition, published on the 40th anniversary of Lucy Squire’s first edition, comes at a time when radiology is undergoing a dramatic evolution, in terms of not only the types of images produced, but also the easy accessibility of these images via PACS to clinicians throughout an entire medical enterprise. These facts, in addition to the intense scrutiny surrounding medical necessity edits for all examinations performed, demand an understanding by everyone in clinical medicine of what the advantages and limitations are in all aspects of imaging. This book serves as a starting point to accomplish these aims.

The book, which is divided into 20 chapters, is written by a single author, Dr. Robert A. Novelline, which gives the book a consistency as one progresses from chapter to chapter. The style of writing should be pleasing to the beginner; it is as if someone is holding a one-on-one conversation with the reader. As one would expect, the images are plentiful and well chosen. Basic principals of radiology, imaging techniques, and normal radiographic anatomy with companion drawings make up the first three chapters, with the basic principals of image interpretations included in each chapter. The remaining chapters cover all areas of the body, with chapters on the lungs, mediastinum, heart, abdomen, musculoskeletal system, vascular system, genitourinary system, mammography, CNS, and interventional procedures and a final chapter on emerging techniques in imaging. Each of these areas is dealt with in varying degrees of thoroughness; for example, there is a more complete survey of the chest, heart and mediastinum than of the CNS. To keep the reader’s interest at a high level, Dr. Novelline intersperses questions and unknowns throughout each chapter, the answers to which are found at the end of the book. Perhaps the most important parts of the book are those areas that tell the student how to look at a chest film, an abdominal study, a spine radiograph, and so forth. It is the method of how to systematically go through a study to pick up all of its main features, which is most valuable.

Perhaps in a seventh edition Dr. Novelline should consider including algorithms for the most common medical problems that are referred for imaging. Although the specifics of these alogrithms could be controversial, clinicians and medical students should know that when they are faced with different imaging modalities, which can visualize the diseases, there is a roadmap to guide them to the most efficacious path to the answer. The over ordering of studies is a problem faced by nearly every radiology department, and the sooner students learn which specific study to order to get the answer, the better.

As radiology moves increasingly towards becoming a required course in medical school curricula, as opposed to an elective, Dr. Novelline’s Squire’s Fundamentals of Radiology fits perfectly as a necessary text.