Agreement between Research Diagnostic Criteria for Temporomandibular Disorders and magnetic resonance diagnoses of temporomandibular disc displacement in a patient population

D Manfredini, L Guarda-Nardini
International Journal of Oral and Maxillofacial Surgery 2008, 37 (7): 612-6
The aim of this work was to evaluate the agreement between the clinical Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) examination and magnetic resonance (MR) findings of temporomandibular joint (TMJ) disc position abnormalities in a sample of clinically symptomatic patients, recruited from a population seeking TMD treatment. Two-hundred and thirty-two TMJs of 116 patients were evaluated to detect disc position abnormalities by means of a standardized clinical assessment according to RDC/TMD guidelines and MR performed blind by a radiologist. The overall kappa value for agreement between clinical examination according to RDC/TMD classification system and MR imaging for assessment of the disc-condyle relationship was fairly good (K=0.63). The kappa values for the agreement between RDC/TMD and MR diagnosis of disc displacement with reduction (DDR), disc displacement without reduction (DDNR) and normal disk position were 0.69, 0.57, and 0.61, respectively. The observation that clinically predicted cases of DDR and DDNR show good to excellent agreement with MR findings, and the potential MR over-diagnosis of DDR and DDNR in the absence of clinical symptoms, support the usefulness of a standardized examination conducted by a trained investigator in the evaluation of patients with TMD.

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