Diagnostic accuracy of upper compartment arthroscopy of the temporomandibular joint: correlation with postmortem...

The diagnostic accuracy of upper compartment arthroscopy of the temporomandibular joint was evaluated in fifty fresh human cadavers. Arthroscopic observations of remodeling, arthrosis, adhesion, and perforation were compared with dissection findings. About half of the joints were arthroscopically diagnosed in agreement with subsequent dissection findings. In the other joints there were discrepancies between arthroscopic and morphologic findings. The discrepancies were, with only two exceptions, underdiagnosis of pathologic changes. This was most pronounced for perforation of the disk, since only three of fourteen perforations were seen through the arthroscope. The position of the disk was difficult to study arthroscopically, since the injected air and the thick arthroscope in the joint compartment altered the positional relationship between the joint components and made it difficult to reproduce joint function during the examination. In conclusion, arthroscopy of the upper compartment of the temporomandibular joint provides information about the articular surfaces that is not available by other methods, and this examination may therefore be a valuable supplement to other diagnostic methods, and this examination may therefore be a valuable supplement to other diagnostic methods. An arthroscopic diagnosis of pathologic changes seems to be reliable (high specificity), but an arthroscopic diagnosis of normality includes a substantial risk of underdiagnosing pathologic changes (low sensitivity).