Iffat Batool Syed, Assad Abbas, Hasnain Abbas.
Comparison of research diagnostic criteria with magnetic resonance imaging in patients with myofascial pain.
Pak Oral Dental J Jan ;35(3):434-8.

Temporomandibular disorders affect a considerable percentage of population. Myofascial pain is the most common of temporomandibular pain due to occlusal disharmony, jaw clenching, anxiety and other factors. The objective of this study was to compare the research diagnostic criteria for temporomandibular disorders with magnetic resonance imaging to determine validity for correct clinical diagnosis of patients having myofascial pain. The diagnoses from the clinical examination of 54 joints in 27 patients were compared with magnetic resonance imaging diagnoses. The readers of magnetic resonance images were blinded to the clinical diagnoses. Comparative cross sectional study was undertaken. 38 joints (70.4%) were clinically diagnosed with myofascial pain whereas 29 joints (53.7%) were shown to have myofascial pain by MRI examination. The results of our study showed that clinical diagnosis according to research diagnostic criteria for temporomandibular disorders is insufficiently reliable for diagnostic accuracy in comparison with magnetic resonance imaging, a gold standard. The kappa value for the agreement between clinical and magnetic resonance imaging diagnoses was 0.045. Kappa statistics measures the agreement in excess of chance with kappa values ranging between 0 and 1; values lower than 0.4 are considered to have poor agreement and 1.0 represents perfect agreement.

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