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Pediatric Sacroiliac Joint: Normal Development and Pathologic Disorders
Daisy Terumi Kase1,2, Paola Cecy Kuenzer Goes Esmanhotto1,2, Lucas Kenzo Miyahara1,2
1Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, Vila Clementino, São Paulo, SP 04024-000, Brazil.
Summary
Pediatric sacroiliac joint (SIJ) imaging presents challenges due to unique anatomy and developmental variations mimicking pathology. Accurate differentiation of SIJ findings is crucial for appropriate diagnosis and treatment in children.
Area of Science:
- Pediatric Radiology
- Musculoskeletal Imaging
- Anatomy
Background:
- The pediatric sacroiliac joint (SIJ) has distinct anatomical features compared to adults, complicating imaging interpretation.
- Developmental variations and normal findings can mimic pathological conditions on imaging.
- Accurate differentiation is essential to prevent misdiagnosis and unnecessary interventions.
Purpose of the Study:
- To enhance radiologists' understanding of the pediatric SIJ.
- To review unique anatomical characteristics and key imaging features of the pediatric SIJ.
- To discuss pertinent differential diagnoses for pediatric SIJ abnormalities.
Main Methods:
- Review of imaging findings in the pediatric sacroiliac joint.
- Discussion of common developmental variations (subchondral irregularities, flaring).
- Analysis of imaging features associated with inflammatory, infectious, and traumatic sacroiliitis.
Main Results:
- Subchondral irregularities and flaring are common developmental findings that can be mistaken for pathology.
- Inflammatory, infectious, and traumatic causes of sacroiliitis have distinct imaging indicators.
- Unilateral sacroiliitis may suggest infection, while mechanical overload can cause bone marrow edema or stress fractures.
Conclusions:
- Radiologists must be aware of unique pediatric SIJ anatomy and common variations.
- Differentiating normal variants from true pathology is critical for optimal patient management.
- Comprehensive understanding aids in accurate diagnosis and avoids functional impairments.
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