Imaging findings of sacroiliac joint degeneration are prevalent in asymptomatic adults: a systemic review and meta-analysis

Abstract Objective The purpose of this study is to determine the prevalence of imaging findings of sacroiliac joint (SIJ) degeneration in asymptomatic adults. Materials and methods All studies reporting the prevalence of cross-sectional imaging findings of SIJ degeneration in asymptomatic adults through May 2026 were included. Pooled prevalence and 95% confidence intervals were calculated using a random-effects model. Heterogeneity was assessed with I 2 and Cochran’s Q . Age and sex subgroup analyses were performed. Results Seventeen studies (3873 patients) were included. Any feature of degeneration was observed in 71.1% of patients (95% CI [25.8, 94.6]) with significant heterogeneity among studies ( I 2 = 96%, p < .01). Osteophyte formation was most prevalent (68.4%; 95% CI [37.5, 88.7], I 2 = 92%), followed by joint space narrowing (45.2%; 95% CI [9.8, 86.3], I 2 = 99%), subchondral sclerosis (39.1%; 95% CI [11.7, 75.7], I 2 = 96%), vacuum phenomenon (14.3%; 95% CI [6.4, 28.7], I 2 = 94%), subchondral cyst formation (5.5%; 95% CI [3.0, 9.9], I 2 = 59%), erosions (5.0%; 95% CI [2.1, 11.2], I 2 = 86%), and joint ankylosis (2.8%; 95% CI [1.2, 6.5], I 2 = 66%). There was a correlation between age and osteophytosis, subchondral sclerosis, and vacuum phenomenon. Conclusion Our study reveals a high prevalence of imaging findings related to SIJ degeneration in asymptomatic adults, which may have a connection with age in several findings. These findings emphasize the importance of correlating imaging with clinical symptoms and physical examination findings in the evaluation of low back pain. Findings should be interpreted with caution because confidence intervals were wide and between-study heterogeneity was high, reflecting differences in imaging modality, lesion definitions, and patient categorization.