Influence of size and shape of the auricular surfaces on subchondral bone density distribution in the sacroiliac joint

The sacroiliac auricular surface has a variable morphology and size. The impact of such variations on subchondral mineralization distribution has not been investigated. Sixty‐nine datasets were subjected to CT‐osteoabsorptiometry for the qualitative visualization of chronic loading conditions of the subchondral bone plate using color‐mapped densitograms based on Hounsfield Units in CT. Auricular surface morphologies were classified into three types based on posterior angle size: Type 1: >160°, Type 2: 130–160° and Type 3: <130°. Auricular surface size was categorized based on the mean value (15.4 cm(2)) separating the group into ‘small’ and ‘large’ joint surfaces. Subchondral bone density patterns were qualitatively classified into four color patterns: two marginal patterns (M1 and M2) and two non‐marginal patterns (N1 and N2) and each iliac and sacral surface was subsequently categorized. ‘Marginal’ meant that 60–70% of the surface was less mineralized compared with the highly dense regions and vice versa for the ‘non‐marginal’ patterns. M1 had anterior border mineralization and M2 had mineralization scattered around the borders. N1 had mineralization spread over the whole superior region, N2 had mineralization spread over the superior and anterior regions. Auricular surface area averaged 15.4 ± 3.6 cm(2), with a tendency for males to have larger joint surfaces. Type 2 was the most common (75%) and type 3 the least common morphology (9%). M1 was the most common pattern (62% of surfaces) by sex (males 60%, females 64%) with the anterior border as the densest region in all three morphologies. Sacra have a majority of surfaces with patterns from the marginal group (98%). Ilia have mineralization concentrated at the anterior border (patterns M1 and N2 combined: 83%). Load distribution differences related to auricular surface morphology seems to have little effect on long‐term stress‐related bone adaptation visualized with CT‐osteoabsorptiometry. Higher iliac side mineralization was observed in larger joint surfaces and age‐related morphomechanical size alterations were seen in males.