James Herriot observed that the vastness of veterinary knowledge can be akin to exploring a galaxy where the veterinarian is “groping about on the fringes of limitless space.” This can particularly be true of the proficient interpretation of radiographs, as successful interpretation requires a detailed knowledge of anatomy, awareness of top differentials appropriate to the case, and the ability to detect subtle radiographic changes. My imaging professors in veterinary school used to say an imaginoscope may be needed for veterinary students to spot some of the subtleties that the expert eye could easily perceive. That is where the value in this book lies, because it strengthens interpretation skills so that the practitioner can more confidently approach the galaxy of radiographic imaging interpretation. In addition to the small animal practitioner, this book could be useful for veterinary students preparing for exams.
The book is divided into 3 roughly equal sections: thoracic, abdominal, and musculoskeletal imaging. In the typical style of the self-assessment review series, a case-based approach is taken. Signalment and case history are presented along with radiographs to interpret. At the end of each section there is an answer key with a detailed description of radiographic findings. In some cases additional images, other examples of the same lesion in a different patient, or follow-up advanced imaging are provided.
There are approximately 200 cases in this book and most of the radiographs are good quality but the inability to adjust exposure, as can be done with digital radiographs, does hamper interpretation in a few cases. For example, I was convinced that a case was dealing with radiolucent uroliths; however, in the answer key the uroltihs were said to be radioopaque but this was not apparent even in good lighting with a magnifying glass.
Some of the incidental findings can be challenging to see but serve as a good reminder to thoroughly view an entire radiograph including body systems that are not the primary focus.
For more subtle cases, it would have been helpful to have arrows pointing out the exact lesion described. In particular, it would be ideal to label some of the computed tomography (CT) or magnetic resonance (MR) images included in the answer key because readers are likely less proficient in interpreting advanced images.
Going through the cases reveals knowledge areas that need to be strengthened, often when the answer key reveals lesions missed or incorrectly interpreted by the reader. For instance, I realized I needed to review the nuances of elbow anatomy. When that needed refresher was coupled with the careful study of musculoskeletal in case 3.4, I now feel more confident in perceiving the subtleties of shape differences in the dysplastic medial coronoid process of the ulna.
Just as looking up the definition of one word in the dictionary can lead to reading about related word definitions; cases in this book kindle an interest in knowing more about the category of disease represented. For example, after reading cases on puppy and kitten cardiac disease, I was inspired to review common pediatric cardiac conditions and their imaging manifestations. Often looking at one example of a disease led to searching for additional images of that condition on the Veterinary Information Network.
Scattered throughout the book are pearls of wisdom, insights that act as a key to aid in interpretation of future cases. One such pearl, for example, is that the trachea is often ventrally displaced in cases of megaesophagus.
Overall, this book inspired me to take more time in interpreting radiographs I see in practice and to more precisely describe the lesions in proper detailed anatomical language in medical records. Reading this book builds confidence and renewed interest in imaging interpretation.