TMJ Scale Report The TMJ Scale Report may be used as a research tool for epidemiological studies, group comparisons, and to document and study patient symptom profiles pre- and post-treatment to assess treatment effectiveness and changes in symptoms over time. Interpretive statements are derived from the magnitude of scale score deviations from cutoffs which research has shown to optimize sensitivity and specificity. The inferences herein should not be viewed or used as definitive judgements, but rather as probabilistic and suggestive. Report results should only be used as an aid to supplement thorough clinical evaluation and other studies rather than for direct clinical decision making. This report should be considered confidential. Patient ID: WFG-12-3456 Date Taken: 07/02/02 PRC ID: A-34505 Clinician Initials: RDW Report Date: 7/01/02 Sex: Female Age: 44 Marital Status: Married Ethnic/Racial: White No. School Years: 16 Problem Length: 1-2 Years Report confidence: Acceptable. Verification Mode: none. Non-Patient Norms Raw T-Score % Rank Domain Dimension Score Female Female Physical Pain Report (PR) 2.00 76 99+ Palpation Pain (PP) 1.57 75 99+ Perceived Malocclusion (MO) 1.50 63 90 Joint Dysfunction (JD) 1.43 66 94 Range of Motion Limitation (RL) 2.20 71 98 Non-TM Disorder (NT) 1.67 73 99 Psychosocial Psychological Factors (PF) 2.00 68 96 Stress (ST) 1.88 66 95 Chronicity (CN) 1.33 68 96 Global Global (GS) 1.88 79 99+ TMJ Scale Report is a trademark of Pain Resource Center, Inc. Copyright (C) 1987 Pain Resource Center, Inc. All rights reserved. 1 TMJ Scale Profile Patient ID: WFG-12-3456 Date Taken: 07/02/02 PRC No.: A-34505 T-SCORE Plotted versus Female Non-Patient Normals % RANK 100+--------------------------------------------------------------------+ | | | | | | | | 90+ | | | | | | | | | 80+ ____ +99+ | | | | | +----+____ | | | | | . | ____ | | | | | . | ____ | | | | | 70+ | . | | __ | | | | | +98 | | . | | | | | +----+ +----+ | | | | | . | +----+ | | | | +----+ | | | | | | . |____| . | | | | . . | | -- | | | | -- . . __ . __ . | | -- | | . __ . | | | | 60+ | . . . . | | | | . . | | | +84 | | . __ . . . | | | | -- . . | | | | | | . . . . | | | | . . __ | | | | | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | 50+ | . . . . | | | | . . | | | +50 | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | 40+ | . . . . | | | | . . | | | +16 | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | 30+ | . . . . | | | | . . | | | +2 | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | | | . . . . | | | | . . | | | | 20+ | . . . . | | | | . . | | | +.1 | | . . . . | | | | . . | | | | +---+----+----+----+----+----+-+----+----+----+----+----+---+----+---+ PR PP MO JD RL NT PF ST CN GS Physical Domain Psychosocial Domain Global T-Score = 76 75 63 66 71 73 68 66 68 79 % Rank = 99+ 99+ 90 94 98 99 96 95 96 99+ Cutoff for Significance = -- TMJ Scale Profile is a trademark of Pain Resource Center, Inc. Copyright (C) 1987 Pain Resource Center, Inc. All rights reserved. 2 TMJ Scale Report Narrative Patient ID: WFG-12-3456 Date Taken: 07/02/02 PRC ID: A-34505 Global Scale The Global Scale is the best single predictor for the presence of a TM disorder, which includes dysfunction of the muscles of mastication and/or of the temporomandibular joint. The Global Scale score in this patient fell at the 99+ percentile relative to the non-patient normative population and therefore appears clinically significant, and indicates the likely presence of a TM disorder. Physical Domain The physical domain scales assess 5 critical areas of dysfunction often associated with TM disorders. Ranking these scales in decreasing order of significance: Rank Order Scale Clinical Significance 1 Palpation Pain significant 2 Pain Report significant 3 Joint Dysfunction significant 4 Perceived Malocclusion significant 5 * Range of Motion Limitation significant * rank of scale ties with previous scale Pain Report sites include TM joint, jaw, ear, posterior auricular, masseter, digastric, trapezius, sternocleidomastoid, and temporalis. Palpation Pain sites include lateral TMJ ligament, external auditory meatus, temporalis, masseter, digastric, trapezius, and sternocleidomastoid. Perceived Malocclusion is associated with the patient's report that her bite feels off, uncomfortable, and like it's changing. Joint Dysfunction symptoms include clicking or popping, grating or grinding, loud noises, closed locking, and lack of smooth movement. Range of Motion Limitation is associated with pain on opening wide, limitation of opening, and limitation in protrusion. TMJ Scale Report Narrative is a trademark of Pain Resource Center, Inc. Copyright (C) 1987 Pain Resource Center, Inc. All rights reserved. 3 Patient ID: WFG-12-3456 Date Taken: 07/02/02 PRC ID: A-34505 Psychosocial Domain Psychosocial factors may contribute both to the onset or maintenance of TM disorders and also reflect the patient's reaction to illness. The Psychological Factors scale, which screens for the patient's overall present state of emotional functioning, fell at the 96 percentile. This indicates that the patient portrays herself as having more emotional difficulties than 96% of the non-patient normative population. This patient reports tension and worry, anxiety, sadness and depression, anger, frustration, nervous problems, and use of nerve or sleeping pills or alcohol for relief. Psychological factors thus appear clinically significant in this patient and therefore further evaluation and intervention (or referral) are suggested. The Stress scale screens for the patient's overall level of stress, both chronic and recent, by assessing various experiential, environmental and behavioral parameters. The Stress scale score fell at the 95 percentile, indicating that this patient is experiencing more stress than 95 out of 100 persons in the non-patient normative population. This patient reports stress related pain, chronic stress, recent stress, clenching teeth, grinding teeth, and sore teeth and tired jaw in the morning. This patient's reported stress level thus appears clinically significant and therefore further evaluation (or referral) and stress management approaches are indicated. The Chronicity scale incorporates a number of historical and perceptual factors which are associated with a propensity toward, or the presence of, chronic illness. This patient's Chronicity scale score is greater than 96% of the non-patient normative population. Therefore, chronicity appears significant and thus suggests that this patient may be predisposed to develop, or already have, a chronic condition. Non-TM Disorder The Non-TM Disorder scale screens patients with TM disorders for a variety of symptoms associated with other head and neck problems such as tension and vascular headache, sinusitis, otitis, neuralgia, etc. The Non-TM Disorder scale score fell at the 99 percentile, and thus appears clinically significant and suggests the presence of an additional disorder, if a TM disorder is indicated. Summary This patient appears to have a TM disorder. The physical symptom picture is characterized by significant dysfunction in PR, PP, MO, JD, and RL and borderline dysfunction in no particular area. A non-TM disorder is indicated. Psychological factors appear to be playing a significant role. Stress levels are high. The potential for a chronic problem appears significant. 4 Patient ID: WFG-12-3456 Date Taken: 07/02/02 PRC ID: A-34505 TM Patient Norms Non-TM Dental Patient Norms Female Female Scale T-Score % Rank T-Score % Rank PR 54 64 71 98 PP 56 71 71 98 MO 49 47 59 81 JD 51 52 65 93 RL 50 50 66 94 NT 60 83 73 99 PF 63 90 68 96 ST 57 75 65 93 CN 58 79 66 95 GS 51 54 68 96 Raw Item Responses Item Response Item Response Item Response Item Response 1 3 25 4 49 1 73 2 2 1 26 3 50 1 74 1 3 2 27 4 51 1 75 1 4 1 28 3 52 1 76 1 5 1 29 4 53 1 77 2 6 2 30 2 54 0 78 2 7 1 31 1 55 0 79 1 8 3 32 1 56 1 80 2 9 1 33 2 57 2 81 1 10 2 34 2 58 1 82 2 11 0 35 2 59 2 83 1 12 0 36 2 60 1 84 2 13 1 37 2 61 2 85 1 14 2 38 0 62 2 86 2 15 1 39 0 63 1 87 1 16 2 40 2 64 2 88 2 17 1 41 2 65 2 89 1 18 2 42 4 66 2 90 2 19 2 43 4 67 2 91 1 20 2 44 2 68 2 92 2 21 2 45 1 69 1 93 2 22 2 46 2 70 1 94 2 23 3 47 1 71 1 95 2 24 3 48 1 72 0 96 1 97 2 5