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"There is a significant movement in this year's entries, which impacts on results and creates a very complex national picture," said Michael Turner, the director of the Joint Council for Qualifications, which represents the combined examination boards.
The frequency of patients showing absolute abnormalities at the test site and control site for each and combined examination modalities is shown in Table 2.
Concessions have to be made for the vastly increased amount of data arising both from increased patient throughput as well as from the wealth of imaging information from a combined examination.
The distribution of the participants in each group according to the LossGain coding system consisting of both absolute (abnormal Z-scores) and relative (abnormal side-to-side difference) abnormalities for each and combined examination modalities is presented in Additional file 2: Table S2.
In the present study, it was shown that more than 86 % of arthralgia patients and more than 83%% of OA patients diagnosed after each and combined examination techniques presented with at least one or more somatosensory abnormalities compared to an age- and gender- matched reference group (Table 2).
Mechanical hyperalgesia without sensory loss (L0G2) was the most frequent coding in both OA and arthralgia patients diagnosed in accordance with each and combined examination modalities except for clinically diagnosed OA patients, where hypoesthesia to mechanical tactile stimuli along with mechanical hyperalgesia (L2G2) was the leading combination.
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Further, for combined examinations, both pure arthralgia and OA patients diagnosed as OA on all three imaging modalities demonstrated increased sensitivity to pressure pain compared to controls (P < 0.001) (Table 3 and Additional file 2: Table S3).
Further, for CBCT, MRI, and combined examinations, there was no significant difference in the relative PPT changes between the subject group neither at the TMJ (P > 0.116) nor at the thenar (P > 0.423) (Table 5).
Nevertheless, the results from the present study indicate that the CPM effect was intact at both the segmental and extrasegmental sites in both group of TMJ pain patients diagnosed after each and combined examinations.
The frequencies of absolute abnormalities of Z-scores for each QST parameter for controls, arthralgia and OA patients classified based on clinical examination, presence or absence of degenerative changes on CBCT, MRI and HR-US and combined examinations (i.e., pure arthralgia and OA diagnosed as OA on all imaging techniques) are shown in Table 1.
The QST sensory profiles of the arthralgia and OA patients at the test site of the TMJ, shown as Z-scores, for each examination modality are illustrated in Fig. 3 and for combined examinations are illustrated in Additional file 3: Figure S2.
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