Atlas of Normal Roentgen Variants That May Simulate Disease

American Journal of Neuroradiology

Keats, Anderson. 7th ed. Elsevier Science. 1072 pages, 5700 illustrations. $249.00.

The recently released 7th edition of the Atlas of Normal Roentgen Variants That May Simulate Disease by Keats and Anderson continues a tradition started in 1973. Since that 1st edition, this book has become a mainstay in radiology departments and emergency rooms throughout the world. The emphasis remains on conventional radiology, with skeletal variants being the primary focus. Smaller sections concerned with the soft tissues and the chest are also offered. Barium studies and IV and retrograde urography are covered to a lesser extent. Modalities such as CT and MR imaging are used to help explain the various observations.

With each subsequent edition, there are additions and refinements to the collection of cases. In comparing this edition with the previous one, several new variants are noted. Although many of the illustrations are the same, slight reorganization and resizing of the images make the observations clearer. The changes have resulted in expansion of the book by almost 20% to its current size of >1200 pages. As a hardcover 10- by 12-in tome, this is clearly not a pocket or backpack reference book. For example, variants of the skull alone include 346 illustrations on 114 pages.

The captions accompanying each figure constitute the only text in this book. These are concise and descriptive, such as, “Vascular channel simulating a skull fracture.” These explanations fulfill the purpose of the book, and other discussion would be extraneous.

The table of contents is complete and straightforward. Each section is separated into specific anatomic areas, such as the 12 separate headings listed under “The Hand.” This makes it very easy to go directly to the site of concern and try to match the abnormality that the radiologist observes with one of the variants in the book. Twenty-seven illustrations are included for the carpal navicular bone, spanning 10 pages and containing 54 images. It is difficult to imagine not being able to find a match for an abnormality observed in daily practice.

This reference is essential for anyone involved in the field of radiology. Sections are included for all subspecialists, and the book offers overall usefulness for the general radiologist. It probably is not necessary to replace the previous (6th) edition of this book, if that is currently in your library; the few changes might not warrant the $249 list price. It would be more reasonable to replace this atlas every two or three editions, to remain current. The Atlas of Normal Roentgen Variants That May Simulate Disease certainly has its place in every radiology department, imaging facility, and emergency room.