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Book and Media Reviews
August 26, 2009

Kelley’s Textbook of Rheumatology

JAMA. 2009;302(8):900-904. doi:10.1001/jama.2009.1254

Almost a hundred years ago, W. S. C. Copeman defined rheumatology in a textbook that addressed in one place a variety of diseases that had been the subject of articles and monographs defining the specialty. After Copeman's third edition, Hollander added immunology and produced the first US edition in 1940; later, Kelley created another that had a more international flavor. This is its eighth edition.

The 2 volumes are divided into 18 parts: initially, the anatomy and physiology of the joints and connective tissue are discussed. The chapters by the Goldrings are especially complete and useful, but all are important for understanding the affected structures. The second section, “Cells Involved in Autoimmune Diseases and Inflammation,” defines the cells that participate in the diseases; the third section, “Effector Mechanisms,” explains how they function. The next section, “Broad Issues,” details the judgment that comes into play, and the section following that evaluates generalized and local symptoms. The chapter on fibromyalgia, in which Wolfe and Rasker tactfully handle the issues and come up with a soundly reasoned explanation, is particularly impressive. The next section, “Differential Diagnosis of Regional Pain,” is especially useful for patient appraisal, and the diagnostic tests that comprise the section that follows are the linchpins for the students investigating these disorders. Therapy is then addressed and, like the rest of the 2 volumes, the discussion is as contemporaneous as that presented in current journals. In fact, unlike some journal discussions, the text defines the rationales for treatments. Nutrition, rehabilitative medicine, and self-management are addressed, as is how to subdue disease expressions.

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