Oxford Handbook of Rheumatology

832 Pages·2018·6.16 MB·English

by  Gavin Clunie

OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of Rheumatology
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Rheumatology
Fourth Edition
Gavin Clunie
Consultant Rheumatologist and Metabolic Bone Physician,
Addenbrooke’s Hospital, Cambridge, UK
Nick Wilkinson
Consultant Paediatric and Adolescent Rheumatologist,
Evelina London Children’s Hospital, London, UK
Elena Nikiphorou
Consultant Rheumatologist, Whittington Hospital;
Clinical Researcher, Academic Rheumatology Department,
King’s College London, UK
Deepak Jadon
Consultant Rheumatologist and Director of the
Rheumatology Research Unit,
Addenbrooke’s Hospital, Cambridge, UK
Great Clarendon Street, Oxford, OX2 6DP, United Kingdom
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First Edition published in 2002
Second Edition published in 2006
Third Edition published in 2011
Fourth Edition published in 2018
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ISBN 978–0–19–872825–2
eISBN 978–0–19–104394–9
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Foreword
I am pleased to introduce you to the 4th edition of the Oxford Handbook of
Rheumatology. This edition has increased in size, but continues to be just as
accessible. It presents the reader with a pragmatic approach to making a
differential diagnosis. The approach to thinking about how to make sense of the
history and clinical findings is clear. The common rheumatological conditions
are covered well, and the new edition incorporates relevant sections on
paediatric and adolescent rheumatology.
From the days of Sir William Osler, the art of listening to and observing the
patient has been a key focus of what defines a good doctor. Medicine has
advanced considerably since his day, but the core values of a physician have not
changed.
The focus on good clinical history taking and examination technique is a
reminder of the core skill set that we use as physicians. When all else fails, go
back to the basic principles, and back to the patient. This book shows us how
important that skill set is.
Professor Jane Dacre MD, PRCP
President
Royal College of Physicians
London, UK
Preface
Rheumatic musculoskeletal conditions are common both in general and hospital
practice. Musculoskeletal symptoms are a primary feature of many multisystem
illnesses, not only in the autoimmune joint and connective tissue diseases, but
also metabolic, endocrine, neoplastic, and infectious conditions. Symptoms are
also common in the context of injury, age-related change, and psychological
distress. Many conditions in rheumatology are a major source of morbidity and
mortality.
We have kept the format of the previous edition for this version but
importantly have updated the text to include paediatric and adolescent
rheumatology.
Part I remains as a guide to evaluation of rheumatic and musculoskeletal
disease from the point of referral and reflects the way clinical
problems/symptoms present to the clinician in real life. We have considered how
this happens for adults, and new in this version, for children and adolescents,
affected by rheumatological and musculoskeletal disease. The reader will find
detail on musculoskeletal anatomy and functional anatomy in this part of the
book.
Part II remains as the section of the book where the reader can find disease-
specific information (e.g. spondyloarthritis, vasculitis, back pain, and so on). We
have included paediatric sections in each chapter where there is relevance for
disease occurring in children and adolescents, noting the difference in disease
and its management in children and adolescents compared with adults.
Part III remains as medicine management and contains chapters on drugs used
in rheumatology practice, glucocorticoid injection therapy, and rheumatological
emergencies.
We have tried to avoid duplication but cross reference between chapters. We
hope this book is helpful and informative for all doctors, physiotherapists, and
specialist nursing practitioners who are faced with managing people and patients
with undiagnosed musculoskeletal symptoms or established rheumatic
musculoskeletal diseases.
Acknowledgements
The authors would like to acknowledge the work of the co-founder author-editor
of the textbook Dr Alan Hakim for his contribution, whom together with Dr
Clunie, devised and wrote the book from the first edition and co-author-editor Dr
Inam Haq (who joined for the 2nd and 3rd editions), in helping to establish the
Oxford Handbook of Rheumatology as the market leader small textbook for
rheumatology.