Marguelles-Bonnet R E, Carpentier P, Yung J P, Defrennes D, Pharaboz C
Department of Prosthodontics, University Denis Diderot Paris 7, Faculty of Dentistry, France.
J Orofac Pain. 1995 Summer;9(3):244-53.
The aim of this study was to compare the provisional diagnosis based on an initial clinical examination with subsequent findings of magnetic resonance imaging in patients with internal derangement of the temporomandibular joint. Clinical examinations were conducted on 242 patients (198 women and 44 men) who had unilateral (51%) or bilateral (49%) temporomandibular joint internal derangement. They were divided into the following categories: (1) disc displacement with reduction; (2) disc displacement without reduction; (3) "stuck" disc; (4) degenerative arthrosis with or without one of the above; and (5) normal temporomandibular joint of the contralateral side. There was no statistically significant difference in the distribution of disorders on a unilateral or bilateral basis or in the prevalence of disorders in right versus left joints. Based on the high occurrence of matching true-negative data, this study showed a highly statistically significant correlation between the magnetic resonance findings and the clinical data for all categories of derangement. Despite this high correlation, the magnetic resonance imaging and clinical diagnoses matched exactly in only 287 of the 484 joints studied. There was only partial agreement in the remaining 197 joints. The best clinical diagnosis in relation to the magnetic resonance findings was observed in the arthrosis category followed by the categories of normal joint, disc displacement with reduction, stuck disc, and disc displacement without reduction, in descending order. This study strongly suggests that degenerative arthrosis is a result of a long-term displaced disc. The clinical examination alone did not correctly indicate all the structural defects; therefore, it is insufficient for determining the status of the joint.
本研究的目的是比较基于颞下颌关节内紊乱患者初始临床检查的初步诊断与后续磁共振成像结果。对242例患者（198例女性和44例男性）进行了临床检查，这些患者患有单侧（51%）或双侧（49%）颞下颌关节内紊乱。他们被分为以下几类：（1）可复性盘移位；（2）不可复性盘移位；（3）“卡锁”盘；（4）伴有或不伴有上述情况之一的退行性关节病；（5）对侧正常颞下颌关节。在单侧或双侧疾病分布或左右关节疾病患病率方面，差异无统计学意义。基于高比例的匹配真阴性数据，本研究显示磁共振成像结果与所有紊乱类型的临床数据之间存在高度统计学显著相关性。尽管相关性很高，但在研究的484个关节中，磁共振成像和临床诊断仅在287个关节中完全匹配。其余197个关节仅部分一致。与磁共振成像结果相关的最佳临床诊断在关节病类别中观察到，其次是正常关节、可复性盘移位、卡锁盘和不可复性盘移位类别，顺序递减。本研究强烈表明，退行性关节病是长期盘移位的结果。仅临床检查不能正确指示所有结构缺陷；因此，它不足以确定关节状态。
