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| Content Provider | PubMed Central |
|---|---|
| Author | Chaput, Ève Gross, Anita Stewart, Ryan Nadeau, Gordon Goldsmith, Charlie H. |
| Copyright Year | 2012 |
| Abstract | Purpose: To assess the diagnostic validity of clinical tests for temporomandibular internal derangement relative to magnetic resonance imaging (MRI). Methods: MEDLINE and Embase were searched from 1994 through 2009. Independent reviewers conducted study selection; risk of bias was assessed using Quality Assessment of studies of Diagnostic Accuracy included in Systematic reviews (QUADAS); ≥9/14) and data abstraction. Overall quality of evidence was profiled using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Agreement was measured using quadratic weighted kappa (κw). Positive (+) or negative (−) likelihood ratios (LR) with 95% CIs were calculated and pooled using the DerSimonian–Laird method and a random-effects model when homogeneous (I 2≥0.40, Q-test p≤0.10). Results: We selected 8 of 36 studies identified. There is very low quality evidence that deflection (+LR: 6.37 [95% CI, 2.13–19.03]) and crepitation (LR:5.88 [95% CI, 1.95–17.76]) as single tests and crepitation, deflection, pain, and limited mouth opening as a cluster of tests are the most valuable for ruling in internal derangement without reduction (+LR:6.37 [95% CI, 2.13–19.03]), (−LR:0.27 [95% CI, 0.11–0.64]) while the test cluster click, deviation, and pain rules out internal derangement with reduction (−LR: 0.09 [95% CI, 0.01–0.72]). No single test or cluster of tests was conclusive and of significant value for ruling in internal derangement with reduction. Conclusions: Findings of this review will assist clinicians in deciding which diagnostic tests to use when internal derangement is suspected. The literature search revealed a lack of high-quality studies; further research with adequate description of patient populations, blinded assessments, and both sagittal and coronal MRI planes is therefore recommended. |
| Related Links | http://dx.doi.org/10.3138/ptc.2010-54 |
| Ending Page | 134 |
| Page Count | 19 |
| Starting Page | 116 |
| File Format | |
| ISSN | 03000508 |
| e-ISSN | 17088313 |
| Journal | Physiotherapy Canada |
| Issue Number | 2 |
| Volume Number | 64 |
| Language | English |
| Publisher | University of Toronto Press Incorporated |
| Publisher Date | 2012-04-01 |
| Access Restriction | Open |
| Rights Holder | University of Toronto Press Incorporated |
| Subject Keyword | Physical Therapy, Sports Therapy and Rehabilitation Research in Higher Education |
| Content Type | Text |
| Resource Type | Article |
| Subject | Physical Therapy, Sports Therapy and Rehabilitation |
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