The aim of this review was to summarize the research on accuracy of individual clinical diagnostic signs and tests for the presence of temporomandibular disorder (TMD), , and for the subclassifications affiliated with TMD.
The authors conducted hand and computerised searches to identify articles on the diagnostic accuracy of clinical tests and signs. The sources searched are not provided in the online abstract. To be included studies had to have an assessment of individual clinical measures of TMD, a report of the diagnostic accuracy of these measures, and an acceptable reference standard for comparison. Study quality was assessed using QUADAS (Quality assessment of studies of diagnostic accuracy) with sensitivity , specificity and negative and positive likelihood ratios being calculated for each diagnostic test described.
They found that seven studies met the criteria with 3 being of high quality as assessed using the QUADAS tool. All 7 studies used tests to differentiate subclassifications of TMD. The 7 studies included (1) diagnostic tests/signs of joint sounds, (2) joint movements, or (3) clinically oriented pain measures. There were no studies that investigated TMD versus a competing, non-TMD condition.
The authors concluded
Because all of the included studies assessed diagnostic accuracy among subclassifications of individuals suspected of having TMD, the ability of any of these tests to distinguish between patients with TMD versus patients without TMD remains unknown. Because of the lack of clear findings indicating compelling evidence for clinical diagnosis of TMD, and because of the low quality of most of these studies, the data are insufficient to support or reject these tests.
Reneker J, Paz J, Petrosino C, Cook C. Diagnostic accuracy of clinical tests and signs of temporomandibular joint disorders: a systematic review of the literature. J Orthop Sports Phys Ther. 2011 Jun;41(6):408-16. Epub 2011 Feb 18. Review. PubMed PMID: 21335932.