Spondyloarthritis & psoriatic arthritis
Two patterns of sacroiliac joint bone marrow oedema are apparent in AxSpA determined by HLA-B27 status, body mass index or psoriasis
Authors' conclusion
Two predominant yet overlapping SIJ BMO patterns were identified: an upper, BMI- and psoriasis-associated peri-capsular pattern, and a lower, HLA-B27-associated sub-fibrocartilaginous pattern.
Study context
- Population
- ASAS-classified axial spondyloarthritis (axSpA) patients with semi-coronal sacroiliac joint (SIJ) MRI203 evaluable
- Participants
- 233 patients
- Exposure
- Predominant upper vs predominant lower vs symmetrical SIJ bone marrow oedema (BMO) distribution
- Predominant upper BMOn = 50
- Predominant lower BMOn = 88reference
- Outcome
- Associations of SIJ BMO localisation (upper vs lower) with demographic, clinical and disease-related features, incl. psoriasis and obesity
Methodological detailsMRI-based, Leeds axSpA MRI scoring system
- MRI-based
- Leeds axSpA MRI scoring system
Main finding
As reported in the abstract
Features of predominant upper vs predominant lower BMO
- Predominant upper BMO: older, higher BMI, longer disease duration, higher prevalence of psoriasis than predominant lower BMO
- all P<0.05
Observational data: associations, not effects.
Further findings
BMO present (evaluable patients)
- BMO present
- 164 (80.8%)
Predominant upper BMO: bDMARD therapy and SIJ BMO scores on follow-up MRI
- bDMARD associated with significant reductions in upper and total SIJ BMO scores
Original publication
Two patterns of sacroiliac joint bone marrow oedema are apparent in AxSpA determined by HLA-B27 status, body mass index or psoriasis. Joint Bone Spine. Published 26 May 2026. doi:10.
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