Clinical Emergency Radiology . Edited by J. Christian Fox . New York, NY : Cambridge University Press , 2008 ; 649 pp; $150.00 (hardcover) . Emergency physicians (EPs) with enough shifts worked undoubtedly have experienced the sense of anxiety and trepidation when a colleague says, “Do you remember that patient you saw last week?” Concerned over morbidity and mortality, the dread is seemingly worse when the call comes from the radiologist for the missed fracture that you failed to splint or the small pneumothorax that just left the emergency department (ED). While not necessarily radiologic experts, we are responsible for viewing films and making rapid clinical decisions based on our findings. We should be pretty good with emergency radiology, and Clinical Emergency Radiology from J. Christian Fox and Cambridge University Press could aid you in becoming savvier in this segment of our field. As the title indicates, this is an emergency medicine (EM)-focused reference. Classically sized and shaped in the same vein as Rosen’s or Roberts and Hedges’, this textbook and its 649 pages are divided into four parts based on the fundamental radiology modalities utilized in EM—plain radiography, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). Each modality gets seemingly equal billing in terms of page distribution. In general, chapters are anatomically based, but several special chapters are included to address issues specific to radiology, such as the “Physics of Ultrasound” or “CT in the ED: Special Considerations.” Excluding these special topic areas, individual chapters are regularly broken down into the following sections: indications, diagnostic capabilities, imaging pitfalls/limitations, and clinical images. Without an abundance of writing in these sections, the bulk of the material is clinical images with associated details annotating the photos. Clinical Emergency Radiology is educational and focused, providing only the necessary direction. It gives a breadth of information, including imaging decision rules, radiographic pearls, and commonly used eponyms. Valuable information is presented about the findings that an EP is likely to come across. It also addresses all radiologic modalities available to the majority of EPs, as well as the most concerning diagnoses that could arise during the average shift. In several chapters, the clinical images are adjacent to the schematic view, rather than the classic drawing, demonstrating the important anatomic locations. Despite the worthwhile change from other emergency radiology references, this is unfortunately only used in the normal variants and would be beneficial with the abnormal findings and anomalies. When considering the book’s faults, one weakness is structural. The individual pages are substantial and should be able to stand up to long-term daily use in a busy ED, but the bindings unfortunately do not have the strength. After only two shifts, the bindings tore and began to break down. This is unfortunate, as emergency radiology books are best served by finding a place in the ED, near the “view box.” Emergency radiology focuses on the discovery of a life-threatening condition that reveals itself on the ordered images. When writing and printing an emergency radiology textbook, more high-quality images are seemingly better, allowing the reader to view multiple versions of the same problem. Despite the large size, the pages have considerable amounts of unused space, which would be amenable to another view of a subarachnoid hemorrhage or an abdominal aortic aneurysm. In comparison to other emergency radiology texts, this product is more readable but lacks depth, becoming another book of images of questionable quality. Despite the price tag, this book is ideal for medical student and resident education. With relatively brief chapters and images with detailed descriptions, the learner could be directed to read or do a review of a selected chapter in preparation for a clinical shift and then be asked to apply the knowledge gleaned when viewing films of the day’s patient evaluations. For the attending, Clinical Emergency Radiology provides the overview, but is not the text you would necessarily choose for the details. For the cost, alternative references exist.