Diagnostic of intracapsular derangement of TMJ: comparison of clinical examination and condylography
The purpose of this study was to compare the accuracy of two diagnostic modalities: clinical examination and condylography with magnetic resonance imaging (MRI), in diagnosing intracapsular derangement of temporomandibular joint (TMJ). A total of 38 symptomatic (mean age of 26 years) and 20 asymptomatic (mean age of 21 years) subjects underwent thorough evaluation by the three diagnostic modalities. Findings were interpreted by three experienced investigators using diagnostic categories, then the agreement between the diagnostic modalities was studied. Clinical examination and condylography both alone and in combination, was not reliable for structural diagnostic. However with regard of the condyle-disk disunion without reposition, the two diagnostic modalities demonstrated a better agreement with MRI and the combination of the two diagnostic modalities increased significantly the percentage of agreement with MRI (89% to 96% of agreement). With regard of disunion without reposition, the combination of clinical examination with condylography is a valid diagnostic modality. The low reliability of clinical examination and condylography with regard of both normality and disunion with reposition could probably be explained by the young age of the symptomatic population.
A. Giraudeau, F. Cheynet, B. Mantout, J. Déjou, P. Sarrat, J. D. Orthlieb