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One reliability study by Dworkin that used
either the digital palpation or stethoscope technique demonstrated marginally acceptable agreement for detection of joint sounds associated with mouth opening . Examiner agreement was less than acceptable during lateral and protrusive jaw movements.In another study, a split stethoscope with double ear pieces and a single diaphragm were used to allow 2 examiners to listen simultaneously to the same TMJ during repeated jaw opening.