AI Summary & Key Takeaways
AI InsightThe coexistence of silent ADDwR and clicking in nondisplaced joints underscores the limitations of relying solely on auscultation or palpation and supports MRI as an important adjunct in diagnostically ambiguous cases.
📌 3 Key Takeaways
Abstract
Aim To evaluate the diagnostic value of temporomandibular joint (TMJ) clicking as a clinical marker of anterior disc displacement with reduction (ADDwR) by comparing clinical findings with magnetic resonance imaging (MRI). Material and method This retrospective study included 128 TMJ sides from adult patients referred for TMJ symptoms between January 2021 and December 2024. All patients underwent standardized clinical TMJ examination documenting the presence or absence of clicking, and bilateral 1.5T MRI with closed- and open-mouth sequences. Results Clinical examinations identified clicking in 114 of 128 joints (89.1%), while 14 joints (10.9%) were clinically silent. MRI demonstrated ADDwR in 112 joints (87.5%) and normal disc position in 16 joints (12.5%). Among ADDwR joints, 98 (87.5%) presented with clicking and 14 (12.5%) represented silent ADDwR. Of the 114 clicking joints, 98 (86.0%) had ADDwR and 16 (14.0%) had normal disc position, constituting clicking without displacement. Clicking showed high sensitivity for ADDwR (87.5%) but occurred in joints with normal disc position as well. Conclusion TMJ clicking is strongly associated with ADDwR but is neither exclusive to displaced discs nor universally present in reducible disc displacements. The coexistence of silent ADDwR and clicking in nondisplaced joints underscores the limitations of relying solely on auscultation or palpation and supports MRI as an important adjunct in diagnostically ambiguous cases.