A critical piece of joint diagnosis is being able to differentiate the sounds we hear using auscultation. Based on the way load is applied in varying positions we know that in a seated condylar position and through rotation the load is on the medial aspect of the condyle/disc assembly. During translation the load moves out to the lateral aspect. By listening to the joint during rotation, which is the first 10mm or so of opening and the condylar movement on the working side during an excursive we can get information about the disc position. Translation occurs when listening on the balancing side during an excursive or during the rest of the opening movement. Doppler is one of my favorite ways to listen to a joint as both the patient and I can hear the sounds. In this video, recorded as part of a larger segment of the doing a joint exam for HDIQ, I demonstrate using a doppler.
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