When a medical imaging report describes a finding as “unremarkable,” it signifies that no significant abnormalities were observed in the scanned area. This term is generally positive news, indicating that the structures examined appear within expected parameters. It suggests that the radiologist found nothing unusual or worrying during their review of the images.
Understanding SI Joints
The sacroiliac (SI) joints are located in the pelvis, connecting the sacrum, a triangular bone at the base of the spine, and the ilium, the large, fan-shaped bones of the pelvis. There are two SI joints, one on each side of the lower back. These joints transfer weight and forces from the upper body to the legs.
The SI joints also act as shock absorbers for the spine, absorbing forces during activities like standing or walking. While they are true synovial joints, they have a limited range of motion, only a few millimeters of movement. This restricted mobility is due to a strong network of ligaments that stabilize them, allowing for stability while still permitting movement for activities like walking and changing posture.
What Unremarkable Means for Your SI Joints
When an imaging report, such as an X-ray, MRI, or CT scan, states that your SI joints are “unremarkable,” it means that these joints appear normal on the scan. This finding indicates an absence of visible signs of inflammation, degeneration, or misalignment. Radiologists examine the joint space and surrounding bone.
An “unremarkable” finding suggests that there are no obvious fractures, bone spurs (osteophytes), or other pathologies visible on these scans. While often used interchangeably with “normal,” “unremarkable” can also mean minor, age-related changes are present but not clinically significant. This means the radiologist found no issues requiring further investigation based on the scan.
Conditions Affecting SI Joints
Various conditions can make SI joints appear “remarkable” on imaging, causing pain and dysfunction. Sacroiliitis is an inflammatory condition of one or both SI joints, caused by infection, injury, or arthritis. It often presents with pain in the lower back, buttocks, or legs, which may worsen with prolonged sitting or standing.
Degenerative arthritis, or osteoarthritis, is another common issue, involving cartilage wear and tear within the SI joint. This breakdown can lead to bones rubbing together, causing pain, stiffness, and bone spur formation. The SI joint is a common site for osteoarthritis.
Hypermobility, or excessive movement in the SI joint, often due to loose ligaments, can lead to instability and pain in the lower back, hip, and groin. Conversely, hypomobility, or restricted movement, can cause pain, muscle tension, and limited mobility, often affecting one side of the lower back and radiating down the leg. Conditions like ankylosing spondylitis, a chronic inflammatory disease, can cause severe inflammation and eventual fusion of the SI joints, leading to stiffness and reduced motion.
Next Steps After an Unremarkable Finding
Receiving an “unremarkable” imaging report for your SI joints is reassuring, yet some individuals may still experience symptoms like lower back or buttock pain. Imaging reports are only one piece of the diagnostic puzzle. Many sources of pain, such as muscle strains, ligament laxity, nerve impingement, or referred pain, may not be visible on standard X-rays, MRIs, or CT scans.
Even with normal imaging, a physical examination by a healthcare professional is necessary to correlate symptoms with clinical findings. This evaluation often involves specific physical maneuvers to stress the SI joints and assess pain responses. If an SI joint issue is suspected, a diagnostic injection of a local anesthetic into the joint, guided by imaging, can help confirm if the SI joint is the source of the pain.