title: Web-based calibration of observers using MRI of the temporomandibular joint.
abstract: OBJECTIVE
  Research diagnostic criteria for temporomandibular disorders (RDC/TMDs) were proposed in 1992 with the aim of standardizing and testing methods for diagnosing TMDs. RDC/TMDs have so far been lacking standardized methods for imaging and criteria for imaging diagnosis of disorders of the temporomandibular joint (TMJ). Criteria for disorders of the TMJ have recently been proposed for MRI. The aim of this study was to publish MR images of the TMJ on the web and to test the agreement of five observers using the criteria.
  
  
  METHODS
  20 cases of MRI of the TMJ were published on the web together with the criteria. The MR images were taken in closed and open mouth positions, and sagittal and coronal views. Five observers diagnosed disc position, disc shape, joint effusion and loose calcified bodies in the TMJ.
  
  
  RESULTS
  In all cases except one, three or more observers agreed upon the diagnosis. All agreed on whether a loose calcified body was present or not. The second best agreement was obtained for disc position in the sagittal view, where all observers agreed in 16 of the 20 cases. For disc position in the coronal view and the evaluation of the disc shape, observer agreement was lower.
  
  
  CONCLUSIONS
  Criteria were useful in order to standardize and simplify evaluation and thereby probably increase the diagnostic outcome among different observers for MRI of the TMJ. We recommend that the criteria be used internationally to facilitate comparisons between different studies.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, SE-205 06 Malmö, Sweden. kristina.hellen-halme@mah.se
authors.forename: K
authors.initials: K
authors.lastname: Hellén-Halme
authors.forename: L
authors.initials: L
authors.lastname: Hollender
authors.forename: M
authors.initials: M
authors.lastname: Janda
authors.forename: A
authors.initials: A
authors.lastname: Petersson
mesh_terms: D002114:Calcinosis / Q000175:diagnosis; D002138:Calibration; D006801:Humans; D020407:Internet; D007594:Joint Loose Bodies / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008335:Mandibular Condyle / Q000473:pathology; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012015:Reference Standards; D013582:Synovial Fluid; D013704:Temporomandibular Joint / Q000473:pathology*; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*