title: Bone marrow edema on magnetic resonance imaging (MRI) of the sacroiliac joints is associated with development of fatty lesions on MRI over a 1-year interval in patients with early inflammatory low back pain: a 2-year followup study.
abstract: OBJECTIVE
  To assess whether bone marrow edema (BME) detected on magnetic resonance imaging (MRI) of the sacroiliac joints (MRI-SIJ) is associated with development of structural changes on both MRI and pelvic radiographs in patients with early inflammatory back pain (IBP).
  
  
  METHODS
  Patients with IBP ≤ 2 years were followed for 2 years with annual MRI-SIJ. MRI were scored for BME and structural changes (erosions and fatty lesions). Pelvic radiographs were graded according to the modified New York (mNY) criteria. With generalized estimated equation analysis, a time trend in the structural change scores was investigated.
  
  
  RESULTS
  Sixty-eight patients [38% male; mean (SD) age 34.9 (10.3) yrs] were included. During the 2-year followup, pelvic radiograph grading remained constant. On MRI, the number of erosions per patient increased significantly (mean score 2.5 at baseline and 3.5 at 2-yr followup; p = 0.05). A trend was found for an increase in the number of fatty lesions per patient (mean score 5.4 at baseline and 8.5 at 2-yr followup; p = 0.06). Overall, BME was associated with the development of fatty lesions (right SIJ: OR 3.13, 95% CI 1.06-9.20; left SIJ: OR 22.13, 95% CI 1.27-384.50), preferentially in quadrants showing resolution of BME. In contrast, BME (or the resolution thereof) was not associated with the development of erosions.
  
  
  CONCLUSIONS
  BME at baseline, especially when it disappears over time, results in the development of fatty lesions, but an association with erosions could not be demonstrated.
authors.affiliation: From the School for Public Health and Primary Care (CAPHRI), University of Maastricht, and Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Immunology and Rheumatology, Academic Medical Center Amsterdam, Amsterdam; Department of Rheumatology, Atrium Medical Center Heerlen, Heerlen, The Netherlands.M. van Onna, MD; A. van Tubergen, MD, PhD, Department of Medicine, Division of Rheumatology, Maastricht University Medical Center; D.M. van der Heijde, MD, PhD, Leiden University Medical Center; A.G. Jurik, MD, PhD, Aarhus University Hospital; R. Landewé, MD, PhD, Academic Medical Center Amsterdam, and Department of Rheumatology, Atrium Medical Center Heerlen. m.van.onna@mumc.nl.
authors.forename: Marloes
authors.initials: M
authors.lastname: van Onna
authors.affiliation: From the School for Public Health and Primary Care (CAPHRI), University of Maastricht, and Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Immunology and Rheumatology, Academic Medical Center Amsterdam, Amsterdam; Department of Rheumatology, Atrium Medical Center Heerlen, Heerlen, The Netherlands.M. van Onna, MD; A. van Tubergen, MD, PhD, Department of Medicine, Division of Rheumatology, Maastricht University Medical Center; D.M. van der Heijde, MD, PhD, Leiden University Medical Center; A.G. Jurik, MD, PhD, Aarhus University Hospital; R. Landewé, MD, PhD, Academic Medical Center Amsterdam, and Department of Rheumatology, Atrium Medical Center Heerlen.
authors.forename: Astrid
authors.initials: A
authors.lastname: van Tubergen
authors.affiliation: From the School for Public Health and Primary Care (CAPHRI), University of Maastricht, and Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Immunology and Rheumatology, Academic Medical Center Amsterdam, Amsterdam; Department of Rheumatology, Atrium Medical Center Heerlen, Heerlen, The Netherlands.M. van Onna, MD; A. van Tubergen, MD, PhD, Department of Medicine, Division of Rheumatology, Maastricht University Medical Center; D.M. van der Heijde, MD, PhD, Leiden University Medical Center; A.G. Jurik, MD, PhD, Aarhus University Hospital; R. Landewé, MD, PhD, Academic Medical Center Amsterdam, and Department of Rheumatology, Atrium Medical Center Heerlen.
authors.forename: Désirée M
authors.initials: DM
authors.lastname: van der Heijde
authors.affiliation: From the School for Public Health and Primary Care (CAPHRI), University of Maastricht, and Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Immunology and Rheumatology, Academic Medical Center Amsterdam, Amsterdam; Department of Rheumatology, Atrium Medical Center Heerlen, Heerlen, The Netherlands.M. van Onna, MD; A. van Tubergen, MD, PhD, Department of Medicine, Division of Rheumatology, Maastricht University Medical Center; D.M. van der Heijde, MD, PhD, Leiden University Medical Center; A.G. Jurik, MD, PhD, Aarhus University Hospital; R. Landewé, MD, PhD, Academic Medical Center Amsterdam, and Department of Rheumatology, Atrium Medical Center Heerlen.
authors.forename: Anne Grethe
authors.initials: AG
authors.lastname: Jurik
authors.affiliation: From the School for Public Health and Primary Care (CAPHRI), University of Maastricht, and Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Immunology and Rheumatology, Academic Medical Center Amsterdam, Amsterdam; Department of Rheumatology, Atrium Medical Center Heerlen, Heerlen, The Netherlands.M. van Onna, MD; A. van Tubergen, MD, PhD, Department of Medicine, Division of Rheumatology, Maastricht University Medical Center; D.M. van der Heijde, MD, PhD, Leiden University Medical Center; A.G. Jurik, MD, PhD, Aarhus University Hospital; R. Landewé, MD, PhD, Academic Medical Center Amsterdam, and Department of Rheumatology, Atrium Medical Center Heerlen.
authors.forename: Robert
authors.initials: R
authors.lastname: Landewé
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D001853:Bone Marrow / Q000473:pathology*; D004487:Edema / Q000150:complications / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000473:pathology; D017116:Low Back Pain / Q000150:complications / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012446:Sacroiliac Joint / Q000473:pathology*; D055815:Young Adult
keywords: AXIAL SPONDYLOARTHRITIS; MAGNETIC RESONANCE IMAGING; SACROILIITIS