Classifying degenerative joint disease by the RDC/TMD and by panoramic imaging: a retrospective analysis

Summary The purposes of the study were to evaluate the utility of diagnosing degenerative joint disease (DJD) by the clinical finding of coarse crepitus alone, without supporting imaging studies, as defined by the RDC/TMD, and to evaluate the contribution of panoramic radiography as an aid in the d...

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Bibliographic Details
Published in:	Journal of oral rehabilitation Vol. 37; no. 3; pp. 171 - 177
Main Authors:	WINOCUR, E., REITER, S., KRICHMER, M., KAFFE, I.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-03-2010
Subjects:	Adult Arthralgia - classification Arthralgia - diagnostic imaging crepitus Dental Caries - diagnostic imaging Dentistry Female Humans imaging Incidental Findings Joint Dislocations - classification Joint Dislocations - diagnostic imaging Magnetic Resonance Imaging Male Mandibular Condyle - diagnostic imaging Mandibular Condyle - injuries Mandibular Diseases - diagnostic imaging Mandibular Fractures - diagnostic imaging Maxillary Sinus - diagnostic imaging osteoarthritis Osteoarthritis - classification Osteoarthritis - diagnosis osteoarthrosis Osteophyte - diagnostic imaging Osteosclerosis - diagnostic imaging panoramic radiography Paranasal Sinus Diseases - diagnostic imaging Radiography, Panoramic Reproducibility of Results Research Diagnostic Criteria for Temporomandibular Disorders Retrospective Studies Sound Temporomandibular Joint Disc - pathology Temporomandibular Joint Disorders - classification Temporomandibular Joint Disorders - diagnosis Temporomandibular Joint Dysfunction Syndrome - classification Temporomandibular Joint Dysfunction Syndrome - diagnostic imaging Tomography, X-Ray Computed Tooth, Impacted - diagnostic imaging
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Summary:	Summary The purposes of the study were to evaluate the utility of diagnosing degenerative joint disease (DJD) by the clinical finding of coarse crepitus alone, without supporting imaging studies, as defined by the RDC/TMD, and to evaluate the contribution of panoramic radiography as an aid in the diagnosis of DJD. A retrospective analysis of 372 consecutive patients with TMD was conducted. Their panoramic radiographs were evaluated for the extent of their contribution to the final diagnosis. Panoramic radiography was of no diagnostic value in 94·4% of the cases when the group was considered as a whole. When patients diagnosed with DJD were considered separately, panoramic radiography was completely sufficient for reaching the final diagnosis in 20·0% of the cases. In almost 90% of these patients, however, the clinical examination did not support the diagnosis of DJD (no coarse crepitus was found). This raises some doubts about the effectiveness of the clinical examination according to the RDC/TMD and about the utility of panoramic radiography in the definitive diagnosis of DJD, because both techniques have low accuracy (11·1% and 20%, respectively). The present study supports the current recommendations that panoramic radiography should not be ordered routinely to assess DJD, but still it is first choice when any dental problem is suspected. Further additional imaging (computerized tomography, magnetic resonance imaging) should be considered only if there is reason to expect that the findings might affect diagnosis and management. This study adds to recent criticisms of the clinical validity of the RDC/TMD, with regard to DJD.
Bibliography:	ark:/67375/WNG-WPZ1LRMP-W istex:745B555585AAA4F7015B0D4D2075220E871F44EC ArticleID:JOOR2035 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0305-182X 1365-2842
DOI:	10.1111/j.1365-2842.2009.02035.x