Is clinical assessment valid for the diagnosis of temporomandibular jont disk displacement?

The aim of this work was to evaluate the predictive value of clinical
examination for magnetic resonance imaging (MRI) findings of temporomandibular
joint (TMJ) disk position abnormalities. METHODS: Participants in this study were
51 consecutive patients with signs and symptoms of temporomandibular disorders
(TMD). All 102 temporomandibular joints (TMJ) were evaluated to detect disk
position abnormalities by means of a standardized clinical assessement according
to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and MRI
performed by a blinded radiologist at the Section of Prosthetic Dentistry,
University of Pisa, Italy. The accuracy of clinical assessment was evaluated with
respect to MRI. RESULTS: Clinical assessment showed a good predictive value (PV)
for the diagnosis of normal disk position (86.2%) and an acceptable PV for the
diagnosis of disk displacement with reduction (70.3%), while it seems less
accurate in predicting MRI diagnosis of disk displacement without reduction. The
overall agreement between clinical RDC/TMD examination and MRI for the evaluation
of disk position was 77.3%. CONCLUSION: Clinical RDC/TMD examination proved to be
accurate in detecting normal disk position and disk displacement with reduction
but not reliable in predicting MRI diagnosis of disk displacement without
reduction in the temporomandibular joint.