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An exam of retrodiscal tissue can solve some of the mystery of a patient’s joint pain. But just as important as the technical aspects of the exam itself is the way in which we conduct it.

We have to bring an extra level of care to a retrodiscal tissue exam.Useful Thinking for All Occlusion Exams

I wrote about the golden rules of lateral pole palpation and diagnosis in the last “Occlusion or Delusion” post. One of the golden rules I emphasized is how important it is to create the right amount of pressure.

This is a useful way to think about most exams, especially those related to occlusion.

You should always be thinking: “How can I bring an extra level of care to this exam?”

What is Retrodiscal Tissue?

It's always useful to revisit the anatomy of retrodiscal tissue. Retrodiscal tissue is the highly vascular, highly innervated tissue behind the head of the condyle.

It has crucial responsibilities for the joint space. It is the essential joint nutrition that brings in blood and oxygen while removing waste products.

Suffice to say: We should give this type of tissue the attention it deserves.

Adding an Extra Level of Care

There is value to a caring touch in pain treatment.The very fact that you’re providing a retrodiscal tissue exam means that your patient is currently experiencing pain or has experienced it in the past. This is a good reason to proceed with the utmost care and caution.

You don’t want to equate to more pain in a patient’s mind. This is why I always try my best to add as much comfort and personal care to the process as possible.

One way I do this is by literally putting my fingers in patients’ ears for the extra-oral portion of the exam. It sounds weird and socially unacceptable (depending on the patient/you/the area of the country), but it works for a few reasons.

  1. I believe I get better information from the tips of my fingers without gloves.
  2. It’s a way to communicate with patients through a caring touch.

Of course, you should ask the patient ahead of time if this is okay. And make sure you wash your hands in front of them so they can see that you value cleanliness.

This might leave you a little grossed out as well and wondering if the patient ever uses Q-tips. But I suggest you consider taking off the gloves to improve the quality of the exam.

Would you go gloveless to improve patient care? Let us know your thoughts in the comments!