Bone Marrow Edema May be Found in Normals, Athletes and Military Recruits Save

Rheumatology has published a study demonstrating that bone marrow edema as measured by magnetic resonance imaging (MRI) may be found in healthy people, but that such changes do not change with intense physical activity. (Citation source https://buff.ly/2CvbuXD)

These findings are notable in light of recent reports from the ACR 2017 meeting showing that bone marrow edema was  commonly seen in the SI joints of athletes (Abstract #1830) and that MRI evidence of bone marrow edema in the SI joints is not specific for axial spondyloarthritis  (Abstract #1831).

In the current observational study, 22 military recruits underwent an MRI of the SI joints before and after 6 weeks of intense standardized physical training. Bone marrow edema and structural lesions were scored based on the Spondyloarthritis Research Consortium of Canada (SPARCC) method. 

At the beginning, 40.9% of recruits already presented a SPARCC score indicating bone marrow edema; this number showed a nonsigificant increase to 50% after six weeks.  Similarly, the number of positive MRI by ASAS definition was not significantly different in the two time points. 

They found no relationship between symptoms of back pain and bone marrow edema lesions.

The study underscores the necessity to interpret MRI findings of the sacroiliac joints in the appropriate clinical context, even in a young active population.