J Korean Assoc Oral Maxillofac Surg.  2007 Aug;33(4):367-374.

Evaluation of clinical methods in the diagnosis of temporomandibular joint disorders: a comparison study with magnetic resonance imaging

• Kim HW
• Shin SS
• Kim JS
• Kim KY
• Kim YJ
• Hong SM
• Cheon SH
• Park YH
• Choi WC
• Park JW

Abstract

PURPOSE
The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement (ID) were tested by comparing the results of them with those of magnetic resonance imaging (MRI).
METHODS
75 patients (150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs.
RESULTS
Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction (ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction (ADDWOR).
CONCLUSION
When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

Keyword

Temporomandibular joint disorders; Articular range of motion; Diagnosis; Magnetic resonance imaging

MeSH Terms

Diagnosis*
Humans
Magnetic Resonance Imaging*
Mass Screening
Mouth
Sensitivity and Specificity
Temporomandibular Joint Disorders*
Temporomandibular Joint*