There are no markings or highlights. It has been stored in a dark place without being used after purchase. Approximately 5 years have passed since the purchase, so there may be slight aging on the cover and cut edges. Please check the images for the condition. The supplementary order card (unfilled) inserted in the textbook is also included. Please purchase only if you understand that this is a home-stored item. Both upper and lower limbs are available. If you wish to purchase both at the same time, please let me know in the comments.