Emshoff R, Rudisch A
Department of Oral and Maxillofacial Surgery, University of Innsbruck. Austria.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Jan;91(1):50-5. doi: 10.1067/moe.2001.111129.
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 predicting magnetic resonance imaging diagnoses of temporomandibular joint internal derangement and osteoarthrosis in a patient pain group with temporomandibular disorders.
One clinician used the Clinical Diagnostic Criteria for Temporomandibular Disorders to classify 163 consecutive patients with temporomandibular disorders on physical diagnosis. The radiologist subsequently performed magnetic resonance imaging on 326 temporomandibular joints. Diagnostic agreement was determined for the diagnostic categories of absence of internal derangement, disk displacement with reduction, disk displacement without reduction, and osteoarthrosis.
Use of the Kappa statistic test indicated a poor diagnostic agreement between the clinician and the radiologist.
The classification system of the Clinical Diagnostic Criteria for Temporomandibular Disorders provides insufficient reliability for determination of the presence of temporomandibular joint internal derangement and osteoarthrosis. It should be supplemented by evidence from cross-sectional and longitudinal investigations to assess decisive differences in the areas of pathogenesis, treatment, and prognosis.
需要开展研究以评估颞下颌关节紊乱病临床诊断标准的有效性。本研究的目的是评估在一组患有颞下颌关节紊乱病的疼痛患者中，临床诊断在预测颞下颌关节内紊乱和骨关节炎的磁共振成像诊断方面的可靠性。
一名临床医生使用颞下颌关节紊乱病临床诊断标准，对163例连续的颞下颌关节紊乱病患者进行体格检查诊断分类。随后，放射科医生对326个颞下颌关节进行了磁共振成像检查。确定了在无内紊乱、可复性盘移位、不可复性盘移位和骨关节炎等诊断类别上的诊断一致性。
使用Kappa统计检验表明临床医生和放射科医生之间的诊断一致性较差。
颞下颌关节紊乱病临床诊断标准的分类系统在确定颞下颌关节内紊乱和骨关节炎的存在方面可靠性不足。应通过横断面和纵向研究的证据进行补充，以评估在发病机制、治疗和预后方面的决定性差异。
