Set line-height on the block with the image to "0" and test again. It is likely the image is placed according to the font baseline. As in:
<fo:block top="0mm" left="0mm" padding="0mm" margin="0mm" background-color="yellow" line-height="0mm" >
<fo:external-graphic padding="0mm" margin="0mm" content-width="100mm" height="200mm" background-color="grey" src="test.jpg"/>
</fo:block>
I tested this with a few formatters and the image goes to the top of the page.