
Sacroiliac joint (SIJ) MRI findings simulating sacroiliitis related to axial spondyloarthritis (axSpA) may occur in women before and after birth. The study aimed to explore the prevalence, evolution, and topography of SIJ MRI lesions in pregnant and postpartum women. Bone marrow edema (BME) was frequent both during pregnancy and postpartum, peaking at 3 months postpartum with a prevalence of 69% but still present in 54% at 12 months postpartum. At 12 months postpartum, 41% of women met the current ASAS sacroiliitis definition, which may result in false positive assignments of axSpA in postpartum women with back pain. Based on the study results, the topographical BME distribution and virtually absent erosions (ASAS threshold) at 12 months postpartum may help discriminate postpartum strain‐related conditions from axSpA‐related sacroiliitis.
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