Comparación de sistemas de evaluación diagnóstica de la severidad de la osteoartrosis en imágenes de TAC de las ATM

Objective:

To compare and validate diagnostic systems for the severity of Osteoarthrosis (OA) of the temporomandibular joints (TMJ) in computed tomography (CT) images.

Method:

An observational, retrospective, analytical, blinded, retrospective study was performed. Ninety-nine patients (198MSCT-ATM) were evaluated, applying the criteria of seven different diagnostic systems. A calibrated clinician (K=0.7) performed the evaluations. Content validity was performed under the Ahmad criteria. Internal consistency was determined with Cronbach’s Alpha. Data were correlated with Spearman’s Rho.

Results:

For condylar erosion severity, there was a high positive correlation between Alexiou/Arayasantiparb (rho=0.986) and a low one between Cömert/Alexiou (rho=0.421) and Cömert/Arayasantiparb (rho=0.422) classifications. For condylar sclerosis, we found a strong correlation between Cömert/Alexiou, Masilla/Alexiou and Cömert/Masilla classifications (rho=857; rho=0.853; rho=0.998). The data presented high internal consistency (Cronbach’s alpha=0.897) and low content validation (36.2%).

Conclusions:

The measurements of the 7 systems have a high reliability. Bone erosion, sclerosis and osteophytes are measured at four levels of severity and with a similar scale in three diagnostic systems (Alexiou, Arayasantiparb and Cömert). We suggest to complement it with the determination of joint space and condylar mobility, as proposed by RDC/TMD. Content validity was low, only the Cömert and Alexiou diagnostic systems were higher than 50%.