Abstract: PURPOSE: The aim of this study was to analyze the reliability and validity of the elimination test of joint clicking for the diagnosis of temporomandibular joint(TMJ) anterior disc displacement with reduction(ADDwR). METHODS: From July 2019 to December 2019, 102 patients who visited the Rehabilitation Department of Shanghai Ninth People's Hospital, complaining of joint clicking were recruited. All the patients received clinical examination and the elimination test of joint clicking by two evaluators, A and B independently. Preliminary diagnosis was made that whether the patient had ADDwR. Then magnetic resonance imaging(MRI) of bilateral TMJ was performed. According to the imaging criteria for MRI diagnosis,articular disc position was divided into 3 categories: normal, ADDwR, and anterior disc displacement without reduction. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of the test were calculated by using MRI diagnosis results as the gold standard. The Kappa coefficient of the elimination test results between evaluators A and B was calculated. SPSS13.0 software package was used for Chi-square test of cross table. RESULTS: The positive rates of A and B were 35%(72/204) and 37%(76/204),respectively. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of evaluator A were 71%, 91%, 85%, 81%, 7.61 and 0.32,respectively, P<0.01. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of evaluator B were 76%, 91%, 85%, 84%, 8.11 and 0.27,respectively, P<0.01. The Kappa coefficient between evaluators A and B was 0.873±0.036（P<0.01）. CONCLUSIONS: The elimination test of joint clicking is simple and easy to operate, which has a good diagnostic value for the determination of TMJ ADDwR.

Key words: Temporomandibular joint, Anterior disc displacement with reduction, Elimination test of clicking, MRI