Disk derangement and inflammatory changes in the posterior disk attachment of the temporomandibular joint. A histologic study.

Temporomandibular joint disk derangements were investigated in 42 patients (47 joints) with respect to occurrence and degree of histologic inflammation in the posterior disk attachment and compared with reference material obtained at autopsy. Sensitivity and specificity for arthroscopy versus macroscopic observation at arthrotomy in regard to inflammation were also investigated. On histologic examination, inflammation was found in 1 joint (5.5%) in the reference material and 30 joints (64%) in the patients where pronounced inflammation was found in 6 joints (20%). Arthroscopy revealed inflammation more accurately (sensitivity 0.94%, specificity 0.86%) than macroscopic observation at arthrotomy (sensitivity 0.58%; specificity 0.90%).