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.
University of Minnesota M.S. thesis. July 20162016. Major: Dentistry. Advisor: Eric Schiffman. 1 computer file (PDF); vi, 18 pages.
Diagnostic accuracy of panoramic radiograph and MRI for detecting signs of TMJ degenerative joint disease.
Retrieved from the University of Minnesota Digital Conservancy,
Content distributed via the University of Minnesota's Digital Conservancy may be subject to additional license and use restrictions applied by the depositor.