Spondyloarthritis & psoriatic arthritis
Bone marrow edema in the sacroiliac joints is associated with the development of structural lesions at the same anatomical location over time in patients with axial spondyloarthritis
Authors' conclusion
In early axSpA, inflammation on MRI-SIJ leads to damage at the quadrant level. The higher the exposure to inflammation across quadrants in the SIJs over time the higher the likelihood of subsequent structural damage, suggesting a cumulative effect.
Study context
- Population
- Patients with early axial spondyloarthritis (axSpA) from the DESIR cohort with ≥2 consecutive MRI-SIJ, assessed at baseline, 2 and 5 years
- Participants
- 196 patients
- Exposure
- Bone marrow edema (BME) patterns over time vs no BME
- Outcome
- Association between BME and subsequent structural lesions (sclerosis, erosions, fatty lesions, ankylosis) on magnetic resonance imaging (MRI) in the same sacroiliac joints (SIJ) quadrant
Methodological detailslongitudinal, quadrant-level analysis
- Longitudinal
- Quadrant-level analysis
Main finding
As reported in the abstract
Structural lesions in the same quadrant with BME (quadrant level)
BMEOdds ratio (95% CI)
Sclerosis
1.9(1.1–3.4)
Erosions
1.9(1.5–2.5)
Fatty lesions
1.9(1.4–2.6)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Higher structural damage on MRI-SIJ (eg ≥5 erosions and/or fatty lesions) by BME pattern · 5 yearsSporadicvs No BME | 2.1 (1.0–4.5) | |
| Higher structural damage on MRI-SIJ (eg ≥5 erosions and/or fatty lesions) by BME pattern · 5 yearsFluctuatingvs No BME | 5.6 (2.2–14.4) | |
| Higher structural damage on MRI-SIJ (eg ≥5 erosions and/or fatty lesions) by BME pattern · 5 yearsPersistentvs No BME | 7.5 (2.8–19.6) | |
| 0.050.21520Odds ratio (log scale) |
- Higher structural damage on MRI-SIJ (eg ≥5 erosions and/or fatty lesions) by BME pattern: gradient between increased level of inflammation and subsequent damage
Original publication
Bone marrow edema in the sacroiliac joints is associated with the development of structural lesions at the same anatomical location over time in patients with axial spondyloarthritis. Semin Arthritis Rheum. Published 18 May 2023. doi:10.
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