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).