Spondyloarthritis & psoriatic arthritis
Evolution of osteitis condensans ilii-like sclerosis in first-time mothers by serial sacroiliac joint magnetic resonance imaging (MRI) during pregnancy and in the postpartum period
Authors' conclusion
Increasing depth of subchondral SIJ sclerosis during and after pregnancy was associated with BME peaking in the early and fat lesion in the late postpartum period suggesting that BME may precede the development of sclerosis and fat lesions.
Study context
- Population
- First-time mothers followed by serial sacroiliac joint (SIJ) MRI from pregnancy to 12 months postpartum
- Participants
- 103 first-time mothers
- Outcome
- Evolution of iliac subchondral SIJ sclerosis
- Follow-up
- Pregnancy week 20 to 12 months postpartum
Methodological detailsserial MRI, three independent readers, MRI at pregnancy weeks 20 and 32 and at 3, 6 and 12 months postpartum
- Serial MRI
- Three independent readers
- MRI at pregnancy weeks 20 and 32 and at 3, 6 and 12 months postpartum
Main finding
As reported in the abstract
Prevalence of iliac subchondral sclerosis
Prevalence at pregnancy week 20
20%
Prevalence at 12 months postpartum
46%
Mean sclerosis depth, expanding from
6.5 mm
Mean sclerosis depth, expanding to
7.5 mm
Observational data: associations, not effects.
Further findings
BME and fat lesions over time
- BME peaked at 3 months postpartum; fat lesions later in the postpartum period
- Expanding sclerosis depth at 12 months postpartum associated with increasing prevalence of BME and fat lesions, but not with pain
BME / fat lesions meeting ASAS thresholds, by sclerosis depth · 12 months postpartum
- Sclerosis ≥8 mm (BME/fat lesions)
- 50/40%
- Sclerosis <8 mm (BME/fat lesions)
- 15/7%
- Significantly more frequent with sclerosis ≥8 mm
Original publication
Evolution of osteitis condensans ilii-like sclerosis in first-time mothers by serial sacroiliac joint MRI during pregnancy and in the postpartum period. Ann Rheum Dis. Published 5 September 2025. doi:10.
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