Spondyloarthritis & psoriatic arthritis
Prevalence and determinants of sacroiliac joint bone marrow oedema in the general population in Germany: a population-based cross-sectional study
Authors' conclusion
Sacroiliac bone marrow oedema affects nearly one-third of adults, showing associations with pregnancy, overweight, and occupational physical stress rather than inflammatory disease.
Study context
- Population
- Adults aged 20–69 years from the German National Cohort who underwent whole-body MRI, May 2014–Dec 20165,432 [48.7%] women
- Participants
- 11,163 adults
- Exposure
- Expert readers vs Deep-learning algorithm
- Expert readersn = 998
- Deep-learning algorithmn = 10,165
- Outcome
- Presence of sacroiliac bone marrow oedema
Methodological detailsnational, population-based, multivariable logistic regression, sex-stratified analyses
- National
- Population-based
- Multivariable logistic regression
- Sex-stratified analyses
Main finding
As reported in the abstract
Prevalence of sacroiliac bone marrow oedema
- Self-reported axSpA diagnosis prevalence (BMO prevalence ≈50 times higher)
- 0.6%
Observational data: associations, not effects.
Further findings
| Outcome | Women | Men | Estimate | |
|---|---|---|---|---|
| BMO prevalence by sex | 33.9% (95% CI 32.6–35.3) | 27.8% (95% CI 26.6–29.1) | aOR 1.33 (95% CI 1.23–1.45) | |
| BMO in women: pregnancy historyvs nulliparous | OR 1.43 (95% CI 1.21–1.71) | |||
| 0.512Ratio (log scale) |
BMO determinants by sex: age and recreational physical activity
- Men: age, OR per decade
- 1.28 (95% CI 1.21-1.35)
- Men: intensive recreational physical activity, OR (1.08-1.42)
- 1.24
- Women: age, OR per decade (1.11-1.23)
- 1.16
BMO determinants overall: BMI ≥25 kg/m² and physically demanding occupational work
- BMI 25 kg/m² and above, OR (1.47-1.79); highest OR of modifiable risk factors
- 1.62
- Physically demanding occupational work, OR
- 1.25 (95% CI 1.14-1.36)
Original publication
Prevalence and determinants of sacroiliac joint bone marrow oedema in the general population in Germany: a population-based cross-sectional study. Lancet Rheumatol. Published 6 May 2026. doi:10.
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