Validation of the clinical diagnostic criteria for temporomandibular disorders for the diagnostic subgroup - disc derangement with reduction

summary Research is needed to assess the validity of the clinical diagnostic criteria for temporomandibular disorders (CDC/TMD). The purpose of this study was to test the reliability of the clinical diagnosis of temporomandibular joint (TMJ) internal derangement type (ID)‐I as compared with the mag...

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Bibliographic Details
Published in:	Journal of oral rehabilitation Vol. 29; no. 12; pp. 1139 - 1145
Main Authors:	Emshoff, R., Brandlmaier, I., Bo¨sch, R., Gerhard, S., Rudisch, A., Bertram, S.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Ltd 01-12-2002
Subjects:	Adolescent Adult Aged clinical diagnostic criteria Dentistry Female Humans Joint Dislocations - diagnosis Magnetic Resonance Imaging Male Mandibular Condyle - pathology Middle Aged Physical Examination - methods Predictive Value of Tests temporomandibular disorders Temporomandibular Joint Disc - pathology temporomandibular joint internal derangement
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Summary:	summary Research is needed to assess the validity of the clinical diagnostic criteria for temporomandibular disorders (CDC/TMD). The purpose of this study was to test the reliability of the clinical diagnosis of temporomandibular joint (TMJ) internal derangement type (ID)‐I as compared with the magnetic resonance imaging (MRI) ‘gold standard’. The study comprised 168 TMJs in 84 patients, who were assigned a clinical TMJ‐related diagnosis of ID‐I (disc displacement with reduction) in at least one TMJ. Bilateral sagittal and coronal MR images were obtained subsequently to establish the corresponding diagnosis of the disc–condyle relationship. For the CDC/TMD interpretations, the positive predictive value (PPV) of ID‐I for disc displacement with reduction (DDR) was 44%, and for the presence of an ID 69%. The overall diagnostic agreement for ID‐I was 47·6% with a corresponding K‐value of 0·05. Most of the disagreement was the result of the false‐positive interpretations of ID‐I, and false‐negative interpretations of an ‘absence of ID’. The results suggest CDC/TMD for ID‐I to be insufficient reliable for determination of ID and/or DDR. Patients assigned a clinical TMJ‐related diagnosis of ID‐I may need to be supplemented by evidence from MRI to determine the functional ‘disc–condyle relationship’.
Bibliography:	ArticleID:JOOR980 ark:/67375/WNG-W7JLQ7WF-8 istex:2739240D4B5F51467E86026B26FCDB03CFB928DC ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0305-182X 1365-2842
DOI:	10.1046/j.1365-2842.2002.00980.x