Rheumatoid arthritis of the temporomandibular joint: radiologic evaluation based on standard reference films

A radiologic scoring system that uses tomography and panoramic radiography to evaluate severity of rheumatoid arthritis in the temporomandibular joint of adults is presented. The scoring system is based on six verbally described grades illustrated by standard reference films. The interobserver agreement was significantly higher for the grading with reference films than for that without reference films. Intraobserver performance was similar for grading with and without reference films. The grading system with reference films is recommended in epidemiologic studies of rheumatoid arthritis localized to the temporomandibular joint or other studies in which multiple observers are involved.