Indian Journal of Rheumatology

: 2021  |  Volume : 16  |  Issue : 2  |  Page : 240--241

Clinical rheumatology

Anand N Malaviya 
 Department of Medicine, and Chief of Clinical Immunology and Rheumatology Services, All-India Institute of Medical Sciences; Department of Rheumatology, ISIC Superspeciality Hospital, New Delhi, India

Correspondence Address:
Dr. Anand N Malaviya
Department of Medicine, and Chief of Clinical Immunology and Rheumatology Services, All-India Institute of Medical Sciences; Department of Rheumatology, ISIC Superspeciality Hospital, New Delhi

How to cite this article:
Malaviya AN. Clinical rheumatology.Indian J Rheumatol 2021;16:240-241

How to cite this URL:
Malaviya AN. Clinical rheumatology. Indian J Rheumatol [serial online] 2021 [cited 2021 Dec 2 ];16:240-241
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Full Text


Editors: Rohini Handa

Edition: First

Publisher: Springer

Year: 2021

Pages: 268

Price: 145.59 Euros

ISBN: 978-981-33-4884-4

“Clinical Rheumatology”[1] (Published by Springer Nature Singapore, 2021) authored by Rohini Handa, (Ex-Professor Medicine, AIIMS, New Delhi, presently Consultant Rheumatology, Indraprastha Apollo Hospital, New Delhi, India) is a new single-authored book in the subspecialty of Internal Medicine and Pediatrics namely, “Rheumatology.” It is a hardbound, 18 cm × 26 cm size small book (only 268 pages) result of a high-class production that has used heavy glossy paper and easy-to-read neatly printed font. The “book” is truly a pleasant surprise. Despite its size, it covers all the aspects of rheumatology, and sundry, with the most updated information, including some of the pivotal recent drug trials and other new useful practical information. “Brevity of the narration yet comprehensive in its coverage” may sound an oxymoron. However, with masterly command on language, Prof. Handa has succeeded in achieving this feat. This is one of the easiest books to read, I could finish it (making small notes in the margin) in just 6 days of my free time.

As stated by the author in the “Preface,” the book aims to fulfil a major gap between several voluminous textbooks of rheumatology and the skimpy coverage of the subjects in the standard textbooks of medicine. In addition, the specific practical problems faced by the patients with rheumatological diseases and the practising rheumatologists in India (and similar developing economies worldwide with their inherent weakness in health services), do not reflect nor addresse these issues. Even some of the available rheumatology texts from India suffer from the same issues of imbalanced narrative and excessive or scant information. This book fulfils the promise made by the author. It covers the subject of rheumatology fully including some of the uncommon conditions. Colour-coded figures, short tables, textboxes and clinical photographs emphasize the salient points that make it easy to remember and memorise. Practice points central to understanding concepts and essential for good clinical care can be easily found in these colour-coded diagrams, tables, flow charts, and text boxes. The beauty of the narrative is to provide just adequate details without being verbose or overwhelming. Areas/topics that are academically “not interesting” yet major issues for the patients have been covered most practically so that the student, as well as the rheumatologist, can easily acquire practical knowledge to help patients with such condition.

The first 2 introductory chapters namely “Bedside Approach to Musculoskeletal Complaints” and “Laboratory Investigations in Rheumatology” are indispensable equally for any student of medicine with aim of becoming a rheumatologist or a practising Internist/Paediatrician. The chapter on “Laboratory investigations” would ensure against the despicable “knee jerk” habit of requisitioning “arthritis panels” (and many irrelevant investigations). The author correctly emphasizes that indiscriminate ordering of investigations is an important reason for misdiagnosis or wrong diagnosis at the level of general practitioners.

For some of the readers, especially the dedicated “Rheumatologists with a keen knowledge of immunology,” the sequence of chapters may appear rather unusual where “Low Back Pain” is the first clinical condition to be dealt with followed by “Osteoarthritis” and then other topics. However, a look at the WHO's list of rheumatic diseases based on the community's epidemiology, these are the two most common musculoskeletal conditions in the world. Therefore, the sequence of chapters in this book is the most logical and scientifically correct. These and other chapters have a uniform presentation where conceptualization and understanding of the disease is the key. Again, the flow charts, diagrams, short tables facilitate reading and understanding the topic under discussion. Despite being a small book, wherever the reader feels that some essential aspects have been given a “pass,” “essentials” are always to be found in the text. Whatever may not have been covered, the author has honestly mentioned “not within the scope of this book.”

Certain chapters in the book entail special mention because these are common problems, but “hardcore immune-rheumatologists” often overlook or ignore these areas. These include “Soft tissue rheumatism,” “Fibromyalgia,” “Complex regional pain syndrome,” “Benign joint hypermobility syndrome,” and “Viral arthritides.” This reviewer learned many new facts while reading these beautifully written chapters, all with recent advances cleverly incorporated in the text.

However, the most useful are the last few chapters that are of immense practical value. These include “Emergencies in Rheumatology,” “Joint aspiration and injection,” “Pregnancy, lactation, contraception and fatherhood in rheumatic diseases,” “Immunisation in autoimmune rheumatic diseases” and “Coronavirus disease and the rheumatologist.” These chapters are of great practical value, not easily found in one place. The practical tips on dos-and-don't with the latest information available in the literature would hold a practising rheumatologist in good stead.

I would strongly recommend this book to undergraduate and postgraduate medical students. Armed with the knowledge gleaned, many of them may be inclined to take up subspecialty of “Rheumatology” as their career choice. For established practising rheumatologists it may be an especially useful “quick updated revision” of the subject of rheumatology. However, possibly, it will be most useful for a DNB/DM (Rheumatology) exam-going student who can revise the whole subject of rheumatology in a few days preceding the examination.


1Handa R. Clinical Rheumatology. Singapore: Springer Nature; 2021.