Validity of clinical diagnostic criteria for temporomandibular disorders -Clinical versus magnetic resonance imaging diagnosis of temporomandibular joint internal derangement and osteoarthrosis

Objectives. Research is needed to assess the validity of clinical decision criteria for the diagnoses of temporomandibular disorders. The objective of this study was to assess the reliability of clinical diagnoses in predicti ng magnetic resonance imaging diagnoses of temporomandibular joint internal derangement and osteoarthrosis in a patient pain group with temporomandibu lar disorders. Methods. One clinician used the Clinical Diagnostic Criteria for Temporoman dibular Disorders to classify 163 consecutive patients with temporomandibul ar disorders on physical diagnosis. The radiologist subsequently performed magnetic resonance imaging on 326 temporomandibular joints. Diagnostic agre ement was determined for the diagnostic categories of absence of internal d erangement. disk displacement with reduction, disk displacement without red uction, and osteoarthrosis. Results. Use of the Kappa statistic test indicated a poor diagnostic agreem ent between the clinician and the radiologist. Conclusions. The classification system of the Clinical Diagnostic Criteria for Temporomandibular Disorders provides insufficient reliability for deter mination of the presence of temporomandibular joint internal derangement an d osteoarthrosis. It should be supplemented by evidence from cross-sectiona l and longitudinal investigations to assess decisive differences in the are as of pathogenesis, treatment, and prognosis.