Research Diagnostic Criteria For Temporomandibular Disorders (RDC/TMD) have been developed in order to standardize clinical examination of TMD. Objectives: The purpose of this clinical, blinded study was to examine the prevalence of TMJ-related diagnoses in patients with myofascial pain based on a) clinical examination and b) magnetic resonance imaging (MRI). Methods: After clinical examination of 57 patients by a calibrated examiner, 40 patients could be divided into 2 subgroups according to RDC/TMD. Sixteen patients presented (1) myofascial pain without limited mouth opening (LMO), whereas 24 patients had (2) myofascial pain with LMO. Additional TMJ diagnoses were assessed by clinical examination and by bilateral MRIs viewed by two raters blinded to clinical diagnoses. Results: Clinical examination of patients with myofascial pain without LMO showed additional joint pathology in 7 subjects (44%) compared to 5 subjects (31%) with MRI. Subjects presenting myofascial pain with LMO clinically demonstrated in 46% (11 patients) an additional joint disease compared to 83% (20 subjects) based on MRI. Kappa statistics revealed an acceptable agreement between joint-related RDC/TMD and MRI diagnoses for patients without LMO (k=0.74) and a poor agreement for patients with LMO (k=0.38). Conclusion: The results indicate that LMO is frequently associated with joint pathology (predominantly disk displacement without reduction) that was not identified by clinical examination.

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