Introduction
Internal derangement of the Temporomandibular Joint (TMJ) is an organic disease, and attempts have been made to identify TMJ disc displacement’s clinical symptoms. Several studies were done to identify clinical signs and symptoms that were predictive of the joint’s status. Various diagnostic imaging techniques were performed, which contributed to the proper diagnosis of TMJ disorders. The most standard and most well-established technique for examining the TMJ radiographically is the transcranial projection. Even more precise depictions of the osseous changes were gained from tomography than from transcranial radiography. With the advent of newer advanced modalities like CT and MRI, both soft and hard tissues can now be viewed in nearly any desired plane of reference with considerable accuracy1-3.
All imaging techniques are not equally effective for each of the different condition that affects the TMJ. The efficacy of any imaging examination rests not just with its technical adequacy but also with its diagnostic accuracy, a complex interaction between the images and the person interpreting it. Besides, the increasing sophistication of imaging techniques does not guarantee a better diagnosis of the patient4,5.
The accuracy of clinical examination for diagnosing the exact status of TMJ internal derangements has been investigated in several previous studies6-9, which have reported the clinical examination’s overall accuracy as 43% to 95%.
False-positives diagnoses are related to over-classification of the disease, which might lead to over-treatment, while false negative diagnoses are related to under-classification and consequently under-treatment8. Now the question arises, how to establish an accurate diagnosis for the internal derangement of the TMJ? Despite various advances in the field of clinical diagnosis of temporomandibular disorders and imaging modalities, i.e., various modifications done in the RDC/TMD since its advent by various societies on temporomandibular joint and imaging technologies, the question remains the same about the best diagnostic criteria and imaging module in order to diagnose the internal derangement of the TMJ.2-4
In order to resolve the confusion regarding the diagnosis and management of the TMD, it was felt necessary to study and compare the efficacy of RDC/TMD diagnostic criteria and MRI as a diagnostic aid in the internal derangement of TMJ. Furthermore, to find out whether RDC/TMD criteria alone is enough for diagnosing the internal derangement of TMJ or its combination with MRI is required whenever seeing the patient with internal derangement. A study was planned to compare the efficacy of RDC/TMD alone or in combination with MRI to diagnose the internal derangement of TMJ.
The study’s specific focus was to correlate the findings of RDC/TMD with advanced imaging techniques like MRI as a diagnostic aid in the Temporomandibular joint’s internal derangement (TMJ).