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Bone and joint futures
  1. T K Kvien
  1. Oslo City Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen, N-0319 Oslo, Norway; t.k.kvien{at}ioks.uio.no

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    “Joint diseases, back complaints, osteoporosis and limb trauma resulting from accidents have an enormous impact on individuals and societies and on healthcare services and economies”. This statement was given by the UN secretary general, Kofi Annan, before the formal launch of the Bone and Joint Decade early 2000. He also stated that there are effective ways to prevent and treat these disabling disorders “but we must act now”. The book Bone and joint futures is a helpful contribution to understand the burden of musculoskeletal diseases and their current and future management, and these topics are especially important issues for the Bone and Joint Decade.

    This book is divided into eight different sections. The first chapter focuses on the future provision of care for musculoskeletal conditions, the second on the future burden of the conditions and priorities for health care, and the third chapter on the potential of developments in bioscience and technology. The last five chapters discuss the future diagnoses and management of five different conditions: rheumatoid arthritis, osteoarthritis, osteoporosis, chronic musculoskeletal pain, and trauma. Each chapter is written by very competent clinicians and epidemiologists.

    The chapters are generally well referenced and provide a lot of useful information to support both clinicians and decision makers in health policy. For example, the demand for care for musculoskeletal conditions is discussed within the framework of change in population demographics, lifestyle changes, peoples’ increasing expectations for health, provision of new treatments, and new technologies as well as the increased costs of health care. Models for care are discussed from different perspectives: the community, the health systems, self management of patients delivery systems, and also how new information technology can be integrated into the management.

    The description of the burden of diseases focuses on the global burden of disease project, the changing demography and, more specifically, on rheumatoid arthritis, osteoarthritis, osteoporosis, and back pain.

    All chapters are easy to read, they are divided into subsections, and an index at the end of the book is also helpful for finding specific information. In this way, the book may also be used as a reference for clinicians and managers of health care to identify specific information when needed.

    The authors have focused on the major conditions of the musculoskeletal system, but of course, not all conditions have been covered. For example, there are no major discussions on the spondyloarthropathies, on undifferentiated polyarthritis, and on gout. The comprehensiveness of references is a little variable across chapters. The limitation of this book, as with most other books, is that the more recent references are not included. For example, no references from 2002 are included and only a few from 2001. Despite this limitation, the message of this book clearly meets the expectations of the title—focusing on the futures of bone and joint management.

    To my knowledge no other book or special issue of a journal covers, the same topic in a similar way. Thus, this book fills an important gap. It will definitely support clinicians when arguing for resources for the care of patients with musculoskeletal diseases and be of special importance to understanding the background and importance of the Bone and Joint Decade.

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