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

(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) Met...

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Autores principales: Knezevic, Milica Jeremic, Knezevic, Aleksandar, Boban, Jasmina, Maletin, Aleksandra, Milekic, Bojana, Koprivica, Daniela Djurovic, Puskar, Tatjana, Semnic, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10297272/
https://www.ncbi.nlm.nih.gov/pubmed/37370881
http://dx.doi.org/10.3390/diagnostics13121986
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author Knezevic, Milica Jeremic
Knezevic, Aleksandar
Boban, Jasmina
Maletin, Aleksandra
Milekic, Bojana
Koprivica, Daniela Djurovic
Puskar, Tatjana
Semnic, Robert
author_facet Knezevic, Milica Jeremic
Knezevic, Aleksandar
Boban, Jasmina
Maletin, Aleksandra
Milekic, Bojana
Koprivica, Daniela Djurovic
Puskar, Tatjana
Semnic, Robert
author_sort Knezevic, Milica Jeremic
collection PubMed
description (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.
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spelling pubmed-102972722023-06-28 High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females Knezevic, Milica Jeremic Knezevic, Aleksandar Boban, Jasmina Maletin, Aleksandra Milekic, Bojana Koprivica, Daniela Djurovic Puskar, Tatjana Semnic, Robert Diagnostics (Basel) Article (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. MDPI 2023-06-06 /pmc/articles/PMC10297272/ /pubmed/37370881 http://dx.doi.org/10.3390/diagnostics13121986 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Knezevic, Milica Jeremic
Knezevic, Aleksandar
Boban, Jasmina
Maletin, Aleksandra
Milekic, Bojana
Koprivica, Daniela Djurovic
Puskar, Tatjana
Semnic, Robert
High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females
title High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females
title_full High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females
title_fullStr High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females
title_full_unstemmed High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females
title_short High-Field Magnetic Resonance Imaging of the Temporomandibular Joint Low Agreement with Clinical Diagnosis in Asymptomatic Females
title_sort high-field magnetic resonance imaging of the temporomandibular joint low agreement with clinical diagnosis in asymptomatic females
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10297272/
https://www.ncbi.nlm.nih.gov/pubmed/37370881
http://dx.doi.org/10.3390/diagnostics13121986
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