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J Prosthet Dent 1992 Feb;67(2):246-251

Interexaminer comparison of bone scintigraphy and panoramic radiography of temporomandibular joints: correlation with signs and symptoms.

Bush FM, Harrington WG, Harkins SW

Department of Restorative Dentistry, Medical College of Virginia, College of Dentistry, Richmond.

Panoramic radiographs of the temporomandibular joints of patients with orofacial pain were examined for evidence of pathology by three different groups of four dental specialists and by a group of four general dentists. Bone scans of the same joints were used as the "gold standard" for identification of disorder and indicated a low rate of correct readings by the four professional groups. When the symptomatic side of the complaint was used as the gold standard, there was no statistically significant association with the bone scan observations. Comparative analysis of other patient symptoms showed little agreement with panoramic radiographs and scintigraphs. Reliability estimates may be highly variable, even among clinical experts. These results show that neither radiologic technique would be definitive for diagnosis of TM disorders.