Normal growth pitfalls mimic pediatric sacroiliac joint disease on MRI

Subchondral irregularities and flaring are common normal developmental findings of the pediatric sacroiliac joint that can be mistaken for pathology. Sacroiliitis is best differentiated by MRI; unilateral involvement with capsular edema or abscess suggests infection. Stress chan…

• Narrative review in RadioGraphics detailing the unique anatomy, normal variants (subchondral flaring/irregularity), and pathologic appearances of the growing SIJ.
• Anatomic variants in cartilaginous and ligamentous components are generally innocuous but some are linked to mechanical overload and pain.
• Traumatic injury is rare in children and usually occurs only with high-energy trauma.

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