How prevalent is sacroiliac joint degeneration? What about among asymptomatic patients?
A new study published in the Journal of Bone and Joint Surgery sought these answers. The researchers examined 500 consecutive pelvic CT scans at a tertiary care medical center. None of the patients had a history of pain in the lower back or pelvic girdle and the images were retrospectively reviewed for SI joint degeneration.
There were 373 CT scans — 746 SI joints — evaluated that met the criteria for the study. Here are five key findings from the authors:
1. The prevalence of SI joint degeneration was 65.1 percent.
2. In 30.5 percent of the images there was substantial degeneration.
3. Prevalence increased with age as 91 percent of patients 90 years or older had some degenerative changes.
4. There isn't an effective or universally-accepted method for diagnosing symptomatic SI joint disorders, according to a response in the same issue of JBJS, and clinicians are incorporating relevant patient-related factors to manage pain.
5. Just because patients have degeneration doesn't mean treatment is necessary; asymptomatic patients may not need treatment, according to the report.
In his response to the article, Jonathan-James T. Eno, MD, wrote, "In the effort to improve our clinical practice, it seems that many of us have momentarily forgotten what our predecessors discovered years ago — the mere CT presence of even severe sacroiliac joint degeneration does not confirm their pathology as the source of pain."