title: Influence of the patient's clinical information on the diagnostic reproducibility and accuracy of MRI scans of temporomandibular joint pathologies.
abstract: OBJECTIVE
  To evaluate the influence of the patient's clinical information on the accuracy as well as interexaminer and intraexaminer reproducibilities of temporomandibular joint (TMJ) magnetic resonance imaging (MRI) scans.
  
  
  METHODS
  Forty MRI scans from 20 TMJs corresponding to 7 TMJ pathologies (ie, degenerative alterations of the condyle, degenerative alterations of the mandibular fossa, alterations in the morphology of the TMJ disc, disc displacement with reduction, disc displacement without reduction, TMJ effusion, and TMJ hypermobility) were assessed by seven uncalibrated specialists in temporomandibular disorders (TMD) at baseline, 30 day-, and 60-day follow-ups for accuracy and reproducibility. No clinical information was provided before the 60-day follow up.
  
  
  RESULTS
  Examiners had a poor to regular accuracy (0.10 to 0.36), kappa index and 5% to 60% correct positive diagnosis) when compared with the radiologist's diagnoses (gold standard). The interexaminer reproducibility ranged from moderate to substantial (kappa = 0.32 to 0.71), and the intraexaminer reproducibility ranged from moderate to perfect (kappa = 0.38 to 1.00). Provision of clinical information improved neither the accuracy nor the reproducibility of the results (P < .05), with the exception of the intraexaminer reproducibility of one examiner.
  
  
  CONCLUSIONS
  Calibration is needed in assessing TMJ MRI scans, even when trained specialists are provided with clinical information from the patient.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Bisi
authors.forename: Eduardo Rolim
authors.initials: ER
authors.lastname: Teixeira
authors.forename: Karen Dantur Batista
authors.initials: KD
authors.lastname: Chaves
authors.forename: Heloisa Emilia Dias
authors.initials: HE
authors.lastname: Silveira
authors.forename: Marcio Lima
authors.initials: ML
authors.lastname: Grossi
mesh_terms: D000293:Adolescent; D000328:Adult; D002138:Calibration; D005157:Facial Pain / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis; D007593:Joint Instability / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008335:Mandibular Condyle / Q000473:pathology; D008487:Medical History Taking; D008875:Middle Aged; D015588:Observer Variation; D010003:Osteoarthritis / Q000175:diagnosis; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D013016:Sound; D013582:Synovial Fluid; D013701:Temporal Bone / Q000473:pathology; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*; D055815:Young Adult