This is a 20 years old on treatment for an auto-immune disease who presented with left hip pain. MRI showed two lesions, of which the subarticular left iliac bone lesion with sacroilitis was the one I decided to biopsy.

We have discussed in the earlier cases, intra-articular approaches to sacroiliac joint biopsies. These were cases 60, 61 and 65.

In this patient, the best approach was the transosseous route. The video describes the approach.