The validity of clinical examination for diagnosing anterior disk displacement without reduction

Abstract

Our results suggest that the predictability of historical or clinical findings to differentiate anterior disk displacement without reduction from other diagnoses is not high.

Diagnostic Accuracy of Clinical Tests and Signs of Temporomandibular Joint Disorders: A Systematic Review of the Literature

“…18 Four articles analyzed crepitation across several subclassifications of TMD diagnoses: osteoarthritis (early), 14 osteoarthritis (late), 14 joint effusion, 18 disc displacement with reduction (DDR), and disc displacement without reduction (DDNR). 33,38 Three of the 4 articles addressing crepitation were of lower quality because of unclear description of the index test (sign) and/or the reference standard, making reproducibility difficult. 14,33,38 One of the articles addressing crepitation had a high QUADAS score (10/14).…”

“…33,38 Three of the 4 articles addressing crepitation were of lower quality because of unclear description of the index test (sign) and/or the reference standard, making reproducibility difficult. 14,33,38 One of the articles addressing crepitation had a high QUADAS score (10/14). 18 This study detailed the execution of the index test and reference standard sufficiently enough to allow replication and eliminated a potential bias by blinding the interpreters of the index test and reference standard to each other.…”

“…14 18,23,31 The subclassifications of TMD presented in the articles included synovitis, 13 effusion, 18 DDR, and DDNR. 23,31,33,38 Four authors looked at pain associated with digital palpation posterior and/ or lateral to the TMJ. 14,18,31,33 The authors performing posterior/lateral palpation described the pain in association with synovitis, 14 effusion, 18 DDR, and DDNR.…”

“…31,38 The required movement was described as opening the mouth as wide as possible with no assistance from the examiner. 31 Two of the authors who described pain 18,38 One of these 3 studies was of higher quality.…”

“…31,38 The required movement was described as opening the mouth as wide as possible with no assistance from the examiner. 31 Two of the authors who described pain 18,38 One of these 3 studies was of higher quality. 18 Two studies, however, were of lower quality, according to the QUADAS, because of a potential bias related to a lack of blinding and lack of detailed description of the index and reference tests to permit replication.…”