Reliability of a negative clinical temporomandibular joint examination: prevalence of disk displacement in asymptomatic temporomandibular joints

Unilateral temporomandibular joint arthrography was performed in 40 healthy volunteers with asymptomatic and clinically normal temporomandibular joints. Thirty-four joints (85%) showed superior disk position, and six joints (15%) were radiographically abnormal with displacement of the disk. Thus, two showed anterior displacement, one showed rotational anterolateral displacement, one showed rotational anteromedial displacement, one showed sideways lateral and one showed sideways medial displacement. Thus, a negative clinical examination for temporomandibular joint internal derangements may involve a risk of being false-negative. All but one of the joints showed normalization of disk position during opening, and it is suggested that lack of functional disturbances accounts for the freedom of symptoms.