Coessens P, De Boever J A
Service de couronnes-bridges et parodontologie, Kliniek voor Tand-, Mond-, en Kaakziekten, Universiteit Gent.
Rev Belge Med Dent (1984). 1997;52(4):139-56.
Establishing the patient's clinical diagnosis depends on gathering as much information of the patient and his or her signs and symptoms as possible. This information can be gathered from history, physical and psychological examination, diagnostic analysis. It is also important to look upon pain as a disorder and to consider the relationship between pain and psychological factors. The differential diagnosis is constructed through a biopsychological model of illness rather than through a more traditional biomedical model of disease. To arrive at a consistently accurate clinical diagnosis in patients with TMJ and craniofacial pain, the technique of clinical diagnosis must be well defined, reliable and include examination of the head and the neck, cranial nerves and the stomatognathic system. The craniomandibular index provides a standardized examination of the stomatognathic system that has been tested on validity and reliability. This chapter focuses on the techniques of history taking clinical and psychological examination and diagnostic criteria for temporomandibular joint disorders and muscle pain.
确立患者的临床诊断取决于尽可能收集患者及其体征和症状的信息。这些信息可从病史、体格检查、心理检查和诊断分析中获取。将疼痛视为一种病症并考虑疼痛与心理因素之间的关系也很重要。鉴别诊断是通过疾病的生物心理模型构建的,而不是通过更传统的生物医学疾病模型。为了对颞下颌关节和颅面部疼痛患者做出始终准确的临床诊断,临床诊断技术必须定义明确、可靠,并且包括对头颈部、颅神经和口颌系统的检查。颅下颌指数提供了对口颌系统的标准化检查,该检查已在有效性和可靠性方面进行了测试。本章重点介绍病史采集、临床和心理检查技术以及颞下颌关节紊乱和肌肉疼痛的诊断标准。