Other strain-related SIJ changes will usually occur in the load-related areas of the joint at the superior/middle anterior portion where subchondral BME, sclerosis and/or fat metaplasia in addition to erosion-like irregularities may occur (doi:10.1186/s13075-022-02760-7).

BME has been reported relatively frequent in patients with mechanical back pain and also in healthy, especially sports active persons, but the BME observed is usually minimal compared to BME in axSpA and deep BME lesions are rarely seen (doi:10.1002/art.40475). The use of STIR sequences in two planes facilitate the exact location of BME and minimize mis-interpretation of changes due to partial volume effect (doi:10.1093/RHEUMATOLOGY/KEZ458).