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Vol 10, No 1, January/February 2002 5 Last year the United States experi- enced a type of violence that has truly shocked the nation and proba- bly changed our country forever. However, before the events of September 11, violence had increas- ingly become an unwanted part of our society. Murders, robberies, and assaults are the obvious symp- toms, but family violence is insidi- ous and even more destructive to the fabric of our society. It often affects those who cannot defend themselves and who, because of perceived dependence, cannot extricate themselves from the abu- sive situation. In the past, we have dealt with child abuse 1 and spousal abuse. 2 The article by Drs. Chen and Koval in this issue focuses on the third type of abuse, that done to the elders of our society. This element is the most difficult because it can have so many different facets. As pointed out by the authors, all states now have laws that specifi- cally target abuse in the elderly and mandate reporting by health care professionals. Although the inci- dence of elder abuse may be as much as 1% to 2% of the noninstitu- tionalized older population, 3 it is less commonly reported than spousal abuse or child abuse. Elder abuse by nature can be emotional, sexual, financial, or physical (either assault or deprivation). This range makes the signs and symptoms of elder abuse even more diverse and harder to comprehend. The diffi- culty in recognition may be com- pounded by the elderly person’s reticence to report abuse because of the fear of being isolated, feelings of dependence, or the fear of family embarrassment. Even when it is reported, elder abuse may be dis- counted as signs of aging, disease, or dementia. Our responsibility as physicians is clear: we must educate ourselves to know what the problem is and how to effectively recognize it. We each need to understand the laws of our own state, the reporting mechanisms, and the agencies that can help our patients. As we were willing to step forward to help with the victims of the terrorist attacks, so we need to be ready to step forward to help the victims of abuse. On a different note, with this issue of the Journal of the American Academy of Orthopaedic Surgeons, we are introducing another new series of articles, “Advances in Therapeutics and Diagnostics.” This new type of article arose from the suggestion of readers as well as members of the editorial board who felt that there are new pharmaceuti- cal agents and techniques for patient evaluation of interest to those who treat musculoskeletal problems. Although much new information appears in the literature each month related to pharmaceutical use and complications, little of it is in jour- nals readily available to the ortho- paedic surgeon. These reviews in JAAOS will focus specifically on the musculoskeletal indications for, complications from, and results from the use of drugs or testing methodologies. As you will see in this initial article, which deals with the fluoroquinolones, the emphasis in this new series will indeed be musculoskeletal. Although most physicians, for example, probably know that ciprofloxacin can be used to treat anthrax, how many are familiar with the fact that one of its more frequent side effects is tendini- tis? We hope you find that this new series enhances your reading of JAAOS and is clinically relevant to your practice. Alan M. Levine, MD Editor-in-Chief References 1. Kocher MS, Kasser JR: Orthopaedic aspects of child abuse. J Am Acad Orthop Surg 2000;8:10-20. 2. Zillmer DA: Domestic violence: The role of the orthopaedic surgeon in identification and treatment. J Am Acad Orthop Surg 2000;8:91-96. 3. Dolan VF: Risk factors for elder abuse. J Insur Med 1999;31:13-20. Matters of Importance