LETTERS
1188
activation status of this population of lymphocytes. In this regard, it will be important to determine the precise compartment in which differentiation into CD27- T cells occurs, as well as the relationship between this and CD70 expression in rheumatoid synovial tissue and draining lymph nodes.
Nancy Oppenheimer-Marks, PhD Peter E. Lipsky, MD The University of Texas Southwestern Medical Center Dallas, TX
BOOK REVIEW Rheumatology Secrets. Edited by Sterling G. West. Philadelphia, Hanky and Belfus, 1997. 568 pp. Illustrated. Indexed. $35.95.
The title of this book suggested to me that rheumatol-
ogy pearls or deeply kept secrets about what causes rheumatic diseases or what to do about them would finally be revealed. Quite to the contrary the book is much more like a traditional textbook, written in a question-and-no-nonsense-answer format. Sections are introduced by quotations to set the toneFlannery O’Connor’s comment that “The wolf, I’m afraid, is inside tearing up the place” is a good a way as any to describe lupus. Most sections can easily be read in 10-15 minutes and provide a summary of key facts about a disease that are the usual banter of teaching rounds, lectures, or examinations. To be sure, there is mention of things one has never heard of before-Gaenslen’s test, Anderson lesions, and the WalkerMurdoch sign were new to me. An up-to-date reading list of key references follows each chapter, and the book is extensively indexed to allow for ready retrieval of the material.
The book is not a substitute for a textbook and differs in several key ways. The reader is guided through a disorder by questions which often test more one’s skill in rote memory (name the 10 causes of) as opposed to the more organized discourse which appears in textbooks. On the other hand, most of the key basic facts are covered. A very attractive feature of the book is that it is in paperback, easily held in one hand, and can be carried about in one’s coat pocket-a great advantage over existing textbooks. Name 3 reasons to buy this book: 1) the book will help students and residents learn rheumatology, shine on rounds, and pass the rheumatology sections of exams with high marks; 2 ) attendings will learn to make teaching rounds more interesting, ask better questions, and know whether the answer is right or wrong; and 3) the book is great fun to read. John H. Klippel, MD National Institutes of Health Bethesda, MD
