High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females

Abstract

(1) Background: The aim of this study was to investigate the agreement between a clinical diagnosis based on research diagnostic criteria/temporomandibular disorders (RDC/TMD) and high-field magnetic resonance imaging (MRI) findings of temporomandibular joints (TMJs) in asymptomatic females. (2) Methods: A prospective study on 100 females (200 TMJs) was performed, using clinical examinations (RDC/TMD) and same-day MRIs of TMJs on a 3T MR unit. The inclusion criteria were as follows: females, age > 18, the presence of upper and lower incisors, and an understanding of the Serbian language. Descriptive statistics (means and standard deviations) and ANOVA with a post hoc Tukey test for differences among the patient subgroups was performed. The agreement between the clinical and MRI findings was determined using Cohen’s kappa coefficient (k < 0.21 slight, 0.21–0.4 fair, 0.41–0.6 moderate, 0.61–0.8 substantial, and 0.81–1 almost perfect). The statistical significance was set at p ≤ 0.05. (3) Results: Normal findings were observed in 86.7%, disc dislocation (DD) was observed in 9.2%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 2.6% of TMJs using RDC/TMD. On the MRI, normal findings were observed in 50.5%, disc dislocation was observed in 16.3%, and arthralgia/osteoarthritis/osteoarthrosis was observed in 23.5% of TMJs. The anterior DD with reduction showed fair agreement of the clinical and MRI findings (k = 0.240, p < 0.001) compared with the DD without reduction (k = 0.355, p < 0.001). Both showed high specificity (94.9% and 99.4%) but low sensitivity (24.2% and 25.0%). The sensitivity in osteoarthritic changes was low (4.8%), but the specificity remained high (96.2%). (4) Conclusions: The sensitivity of the clinical examination remains low compared with 3T MRI, especially in osteoarthritic changes and anterior DD with reduction. However, the number of false positive diagnoses using RDC/TMD is low in asymptomatic patients. RDC/TMD remains a sensible method for establishing a clinical diagnosis and avoiding the overtreatment of asymptomatic patients.

Texture Analysis of Temporomandibular Joint Disc Changes Associated with Effusion Using Magnetic Resonance Images

“…For analysis of soft tissues in the TMJ, MRI is the best method [ 31 , 32 , 33 , 34 ] because it not only provides accurate images and three-dimensional sections but also allows us to visualize relationships with adjacent structures and their functioning [ 35 ].…”

A New Mechanical Mouth Opener for Dynamic Magnetic Resonance Imaging of the Temporomandibular Joint

“…The field of examination of the TMDs is widespread, and there is a large amount of research on this topic [20,38,39], but so far, no tool has been designed that will not burden the budget of the institution where disease diagnosis and further research is carried out. It is necessary to approach it very precisely, given that pain in the TMJ region is the second most common musculoskeletal disorder after chronic low back pain, and, along with the improvement of diagnostic protocols, it would be wise to consider forming teams consisting of dentists, radiologists, psychiatrists, neurologists, and orofacial surgeons in order to make an appropriate choice of therapy and monitoring of the patients with TMDs [40,41].…”