Ray F. Kilcoyne, M.D.(University of Colorado School of Medicine) This is a book of radiologic images of the hand in rheumatoid arthritis. Routine radiographs are included, but the emphasis is on sonography (US) and magnetic resonance imaging (MRI). Imaging techniques are important in the diagnosis, staging, and follow-up of patients with rheumatoid arthritis (RA). Conventional radiographs are insensitive at seeing the earliest pathology to cartilage, tendons, and other soft tissues. US and MRI are important diagnostic tools that radiologists, rheumatologists, and other practitioners should use in their daily treatment of patients with rheumatoid arthritis. This handbook shows numerous illustrations of the destructive changes in the hands as seen on imaging and correlated with clinical and laboratory data. The authors do not include a preface, but a foreword by a senior colleague indicates the book is for residents in radiology, radiologists, and rheumatologists. The book is designed to raise their diagnostic acumen to a higher level. I doubt that radiology residents would spend much time with a specialized handbook of this nature. Practitioners who use musculoskeletal US as part of their practice will find the images helpful. The MR images were obtained on a dedicated extremity scanner, which not many radiologists will have access to. (One of the authors works for the Esaote Group company that manufactures the scanner.) The handbook begins with a description of the clinical and laboratory features of rheumatoid arthritis. Next is a discussion of the imaging features of the disease, including conventional radiography, US and MRI. (Nuclear medicine scanning is not included.) The second half of the book is composed of 25 illustrative cases that include brief clinical and laboratory background and relevant images. One deficiency is the absence of any normal ranges for the laboratory values given. The illustrations are of high quality. In many cases the addition of arrows, especially on the US images, would aid the neophyte in seeing the pertinent pathology. The British writing is clear and concise, although some phraseology will be unfamiliar to American readers. A number of other authors, usually European, have written in the last few years on the value of US and MRI imaging in rheumatoid arthritis. Some rheumatologists have US scanners in their office. This handbook will aid them in learning how to view such images. Few practitioners will have access to a dedicated extremity MR scanner, but the images shown can usually be duplicated on a large-bore body scanner (if the time required and the cost of such a study are not prohibitive).