Validity of clinical diagnostic criteria for temporomandibular disorders: clinical versus magnetic resonance imaging diagnosis of temporomandibular joint internal derangement and osteoarthrosis.
OBJECTIVE
Research is needed to assess the validity of clinical decision criteria for the diagnoses of temporomandibular disorders. The objective of this study was to assess the reliability of clinical diagnoses in predicting magnetic resonance imaging diagnoses of temporomandibular joint internal derangement and osteoarthrosis in a patient pain group with temporomandibular disorders.


METHODS
One clinician used the Clinical Diagnostic Criteria for Temporomandibular Disorders to classify 163 consecutive patients with temporomandibular disorders on physical diagnosis. The radiologist subsequently performed magnetic resonance imaging on 326 temporomandibular joints. Diagnostic agreement was determined for the diagnostic categories of absence of internal derangement, disk displacement with reduction, disk displacement without reduction, and osteoarthrosis.


RESULTS
Use of the Kappa statistic test indicated a poor diagnostic agreement between the clinician and the radiologist.


CONCLUSIONS
The classification system of the Clinical Diagnostic Criteria for Temporomandibular Disorders provides insufficient reliability for determination of the presence of temporomandibular joint internal derangement and osteoarthrosis. It should be supplemented by evidence from cross-sectional and longitudinal investigations to assess decisive differences in the areas of pathogenesis, treatment, and prognosis.
Emshoff
R
R
Department of Oral and Maxillofacial Surgery, University of Innsbruck. Austria. Maxillofaziale-Chirurgie@uibk.ac.at
Rudisch
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003945:Diagnosis, Oral / Q000379:methods*; D004311:Double-Blind Method; D005157:Facial Pain / Q000209:etiology; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010003:Osteoarthritis / Q000175:diagnosis; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D015203:Reproducibility of Results; D013705:Temporomandibular Joint Disorders / Q000145:classification* / Q000150:complications / Q000175:diagnosis*