Steven Waldman’s Atlas of Common Pain Syndromes, Fourth Edition is a succinct, easy-to-read text that is composed of 137 chapters organized into 16 sections. The goal of the text is to offer an illustrated reference manual to aid in the diagnosis of common painful conditions. Each chapter includes a brief description of the syndrome, its presenting signs and symptoms, and its differential diagnosis. Other parts of the chapter cover the necessary diagnostic tests and touch briefly on possible treatments. The bulk of the syndromes described are associated with the musculoskeletal system, although common peripheral nerve entrapment syndromes, headaches, and facial pain are included as well. Worthy of note, with the purchase of the hardcover edition, an e-book is available for download at no extra cost.

One of the main strengths of the book is the large number of illustrations that accompany the text. These radiographs, ultrasound images, computed tomography scans, and magnetic resonance images are designed to make the diagnosis easier and to enhance the reader’s understanding of the underlying pathology. Likewise, the book describes specialized maneuvers during physical examinations that could help establish the correct diagnosis.

The chapters of the Atlas are listed in a head-to-toe sequence, which provides the reader with quick access to the area of interest. Once this area is identified, the reader is often provided with comparative tables that illustrate and contrast the differences between similar conditions. A great example of this is provided in the Headache Pain Syndromes section where different headache characteristics are listed side by side, thereby making the appropriate diagnosis easier.

This new edition of the text has been improved from the previous edition with the expansion of several already existing chapters. For example, the pathologies causing pelvic pain now include endometriosis, pelvic inflammatory disease, and interstitial cystitis. Moreover, Waldman added 13 new chapters in this fourth edition, most of which are associated with abdominal pain.

Although new material is certainly appreciated, one questions the relevance of adding rapidly progressing conditions, such as appendicitis and testicular torsion, to a reference text aimed at clinicians practicing in a chronic pain setting. In addition, there were some commonplace conditions (and corresponding specific diagnostic criteria) that were conspicuously absent from the new chapters. For example, the chapter on migraine headaches does not contain the widely accepted criteria of the International Headache Society. In the same vein, the complex regional pain syndrome chapter lacks the established Budapest criteria. Hence, it appears that although the goal of the Atlas is to point the clinician in the right direction, it occasionally falls short of establishing a clear, confident diagnosis.

In conclusion, Waldman’s Atlas of Common Pain Syndromes, Fourth Edition offers a compact, nicely illustrated manual that focuses mostly on painful musculoskeletal conditions. Compared with other offerings of which this reviewer is aware, the format of the Atlas is unique and could prove useful to pain diagnosticians whose main focus is the treatment of musculoskeletal syndromes. As already mentioned, however, the book offers a less detailed description of some pathologies and is lacking established diagnostic criteria where such exist. Finally, the newly added chapters may not be a strong enough incentive to upgrade to the newer edition of the text as many readers may find them to be outside the scope of their practice.