Predictive value of clinical findings for temporomandibular joint effusion

The aim of this work was to evaluate the predictive value of clinical
symptoms for magnetic resonance imaging (MRI) findings of temporomandibular joint
(TMJ) effusion. STUDY DESIGN: Sixty-one patients with TMJ pain were assessed by
means of a standardized clinical examination and MRI. A calibrated investigator
evaluated the presence of 8 clinical indicators (predictors) of TMJ effusion
(outcome variable). A logistic regression analysis was performed to detect
significant associations between clinical symptoms and MRI findings of TMJ
effusion. The accuracy of the final logit to predict effusion was compared with
that derived from univariate analysis. RESULTS: A clinical examination based upon
the assessment of pain in the TMJ with lateral palpation, with posterior
palpation, during motion, and during maximum assisted opening, and the presence
of click and crepitus sounds has an accuracy of 78.7% to predict TMJ effusion.
Among the single clinical symptoms, the most reliable predictor of TMJ effusion
is the presence of pain with lateral palpation (accuracy 76.2%; K =.525).
CONCLUSION: The use of a multiple regression approach demonstrated that an
extensive clinical assessment which considers 6 main indicators consents to
predict accurately the presence of MRI TMJ effusion. Based on these findings, MRI
assessment should be reserved for patients in which the exact disc-condyle
relationship needs to be evaluated.