Browsing by Subject "Degenerative joint disease"

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    Diagnostic accuracy of panoramic radiograph and MRI for detecting signs of TMJ degenerative joint disease
    (2016-07) Kaimal, Shanti
    Background: To determine the diagnostic accuracy of panoramic radiograph and magnetic resonance imaging (MRI) for detection of signs of temporomandibular joint (TMJ) degenerative joint disease (DJD). Methods: Panoramic radiographs, bilateral TMJ MRI and bilateral TMJ computed tomography (CT) were performed on 705 subjects. Three calibrated board-certified radiologists blinded to the subjects’ clinical findings interpreted all images. Assessment of diagnostic accuracy of panoramic radiographs and MRI for detecting signs of DJD was compared to the reference-standard diagnoses derived from the CTs. DJD was defined by the presence of subcortical cyst, surface erosion, osteophyte or generalized sclerosis. Target sensitivity and specificity were > 70% and > 95%, respectively. Results: For panoramic radiographs, sensitivity and specificity were: subcortical cysts - 14%, 100% respectively; erosion - 20%, 100% respectively; osteophyte - 12%, 100% respectively and generalized sclerosis - 33%, 100%, respectively. For MRI, sensitivity and specificity were: subcortical cysts - 32%, 100% respectively; erosion - 35%, 99% respectively; osteophyte 71%, 98% respectively and generalized sclerosis 50%, 100% respectively. For diagnosis of signs of DJD based on panoramic radiographs, radiologists’ inter-examiner reliability was slight (k=0.16), moderate (k=0.47) when using MRI and substantial with CT images (k=0.71). Conclusions: Panoramic radiographs and MRI had below target sensitivity but above target specificity in detecting all CT-depicted signs of DJD with the exception of detection of MRI-depicted osteophytes, which had adequate diagnostic accuracy. Practical Implications: Use of CT to diagnosis signs of TMJ DJD is recommended to address the false negatives that can occur with panoramic radiographs and MRI.
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    The findings and natural history of radiographic signs of temporomandibular osseous changes in an orthodontic population
    (2013-08) Anderson, Brian Craig
    AIMS: Evaluate the natural history of radiographic temporomandibular joint (TMJ) findings in an orthodontic sample population by interpreting cone-beam CT (CBCT) scans, made before and after comprehensive orthodontic treatment, according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) imaging criteria. METHODS: 348 subjects were included in the study. Pre-treatment CBCTs were interpreted and screening diagnoses were given. Subjects were categorized: control (normal), indeterminate (remodeling), and case (degenerative joint disease [DJD]); these were matched for age and gender. The pre-treatment and post-treatment CBCTs of 76 matched subjects (152 joints) were interpreted and definitive diagnoses were given for each joint. RESULTS AND CONCLUSIONS: There was no statistical evidence that, on average, a worse joint diagnosis existed pre-treatment or post-treatment. The likelihood of having a worse diagnosis post-treatment was statistically significant given a pre-treatment diagnosis of DJD or indeterminate. From pre-treatment to post-treatment 52.6% of diagnoses were unchanged, 25% worsened, and 22.4% improved.