X-rays can show narrowing of the sacroiliac (SI) joint. This joint is subject to arthritis just like any other synovial joint. Narrowing of the joint space points to age-related degenerative changes.
The problem with these findings is that such changes can be seen in any patient over 30 years old. Such changes aren’t always linked to arthritis. Patients can have severe arthritic changes and have no pain. Others have no changes and severe pain.
X-rays can also show bone spurs, osteoporosis, or other changes in the bone itself. It can’t always show infection, inflammation, or instability. Doctors rely on other imaging and clinical tests to rule out more serious causes of SI pain.