Osteitis condensans ilii (OCI) is a benign cause of low-back pain that is self-limiting and has an unknown etiology. It lacks pathological or clinical evidence of inflammation.

The major clinical presentation in OCI is low back pain of mechanical character that is aggravated by activity and relieved upon resting. The patients often describe the non-radicular back pain as radiating down to the posterior thighs.

Usually, the iliac bone near the sacroiliac joint is affected in a bilateral and symmetric process. OCI is predominant in women of child-bearing age. However, rare incidents of men and nulliparous women with OCI is possible. OCI may be unilateral [1].

The sacrum may also be involved since the changes are not always limited to the iliac bones. The joint spaces are generally normal. However, an occasional lipping, and narrowing of the lower margin or minimal irregularities may be observed. Cases have long remissions and even though the onset can be associated with pregnancy, subsequent pregnancies do not necessarily worsen the symptoms. There are no collateral and consistent systemic disturbances or physical and radiological findings [2].

The pregnancy-associated ligamentous laxity of the sacroiliac joint (SIJ) can result in persistent instability and sclerosis of the joint in some cases. This can later present as SIJ tenderness. The course of the disease is chronic and it may relapse.Therefore, OCI should be differentiated from other inflammatory or non-inflammatory disorders of the sacroiliac joint [2] [3].

• Pain

  A 30-year-old woman presented with a ten-year history of low back pain and buttock pain. She was a nulliparous woman and had no history of pregnancy. Her low back pain was mild and developed intermittently. [jrd.or.kr]

  Comparison between the two groups showed no difference in number of pregnancies, newborn weight, presence of back pain, back pain assessed by the Oswestry Low Back Pain Questionnaire or loss of function using the Bath Ankylosing Spondylitis Functional [ncbi.nlm.nih.gov]

  (April 22, 2019) Osteitis Condensans Ilii: An Uncommon Cause of Back Pain. [cureus.com]

• Asymptomatic

  Its presentation is asymptomatic or nonspecific (low lumbalgia). Its very specific radiological image needs to be distinguished carefully in order to avoid diagnostical confusion with ankylosing spondylitis and other causes of sacroiliitis. [unboundmedicine.com]

  Reference work entry 35 Accesses Definition This is an asymptomatic condition of the ilium that is often confused with sacroiliitis on roentgenographic study of the pelvis. There is a high female to male ratio in the patients involved. [link.springer.com]

  Archer, Kate, MB BS † ; Perry, Andrew ‡ ; Beale, Phillip, MB BS, MD, FRACP § ; Van Der Wall, Hans, MB BS, PhD, FRACP † doi: 10.1097/01.rlu.0000124009.40004.45 Interesting Image Abstract Author Information Authors Article Metrics Metrics A 42-year-old asymptomatic [journals.lww.com]

• Disability

  Psychometric properties of the Roland-Morris Disability Questionnaire compared to the Oswestry Disability Index: a systematic review. [physio-pedia.com]

  However not associated chronic back pain or disability. Marrow edema / Radiological malalignment / destruction / soft tissue collection is most uncommon. [sumerdoc.blogspot.com]

  The level of symptoms (BASDAI) and the perceived level of functional disability (BASFI) were comparable between groups. 83% of female patients with OCI reported a history of at least one pregnancy with a mean number of pregnancies of 3 (median=3, range [acrabstracts.org]

  Though OCI symptoms are self-limiting and even radiological findings can disappear with time, it is essential to diagnose OCI as refractory cases can cause a varying degree of disabilities and might require surgical intervention [1,5]. [cureus.com]

• Swelling

  Soft tissue swelling usually implies some swelling or bruising in the fat beneath your skin, but outside your joint ...Read more Dr. Frank Holmes Dr. Holmes 3 doctors agreed: 13 13 Can someone explain this.. [healthtap.com]

  She denied any joint stiffness, swelling, deformity, no skin rash, no eye, and bowel symptoms. She denied any weight loss. Physical examination was normal. Faber’s /Patrick’s test (flexion, abduction, external rotation of hip) was non-revealing. [cureus.com]

• Localized Pain

  Radiating pain was the first to improve abruptly after surgery, followed by gradual simultaneous amelioration of local pain and stiffness. [ncbi.nlm.nih.gov]

• Arthritis

  증례 : Osteitis Condensans Ilii를 동반한 반응성 관절염 1예 A case of reactive arthritis with osteitis condensans ilii Sang-Seokg Seong, Chung-Il Joung ABSTRACT Reactive arthritis that develops after infections outside a joint can manifest as asymmetrical arthritis [ekjm.org]

  Imaging and clinical findings are localized to the sacroiliac joint(s) and thus, must be differentiated from other conditions that may present in a similar fashion (spondyloarthritis, degenerative arthritis, septic arthritis). [ncbi.nlm.nih.gov]

• Joint Tenderness

  CONCLUSION: Osteitis condensans ilii is associated with tenderness during sacroiliac joint compression tests and should be considered in the differential diagnosis when sacroiliac joint tenderness is elicited. [ncbi.nlm.nih.gov]

  While usually an incidental finding, patients with osteitis condensans ilii are more likely to have sacroiliac joint tenderness compared to controls. [roentgenrayreader.blogspot.com]

  CONCLUSION: Osteitis condensans ilii is associated with tenderness during sacroiliac joint compression tests and should be considered in the differential diagnosis when sacroiliac joint tenderness is elicited. [1] References [wikigenes.org]

  Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in women. Jenks K, Meikle G, Gray A, Stebbings S. Jenks K, et al. Int J Rheum Dis. 2009 Apr;12(1):39-43. doi: 10.1111/j.1756-185X.2009.01378.x. [pubmed.ncbi.nlm.nih.gov]

• Musculoskeletal Pain

  Osteitis condensans Ilii: a cause of low back pain? A case-controlled, retrospective study. J Musculoskelet Pain 12(2):65–70 Shipp FL, Haggart GE (1950). Further experience in the manage- ment of osteitis condensans ilii. [clinicalmaze.com]

  Osteitis condensans Ilii: a cause of low back pain? A case-controlled, retrospective study. J Musculoskelet Pain. 2004; 12: 65-70. Olivieri I, Ferri S, Barozzi L. Osteitis condensans ilii. Br J Rheumatol. 1996; 35: 295-297. [austinpublishinggroup.com]

  Osteitis condensans Ilii: a cause of low back pain? A case-controlled, retrospective study. J Musculoskelet Pain. 2004;12(2):65–70. doi: 10.1300/J094v12n02_08. [CrossRef] [Google Scholar] 10. Thompson M, Newton DR, Grainger RG. [ncbi.nlm.nih.gov]

• Muscle Strain

  Hatzicosta General Hospital, Ioannina, Greece Muscle strain of the back was the chief complaint of a 28-year-old woman who presented to the emergency department. [consultant360.com]

  Other differential considerations would include spondylosis of the lumbar spine, osteoarthritis of the femoroacetabular joints, piriformis syndrome, trochanteric or iliopsoas bursitis, muscle strain, or tendinosis. [ncbi.nlm.nih.gov]

• Bone Disorder

  It is a rare benign disorder primarily affecting women of child-bearing age. [biomedsearch.com]

• Suggestibility

  They found nothing suggesting an etiologic factor. Shipp and Haggart (6) later reviewed this same material and extended the series to cover 100 cases. [pubs.rsna.org]

  These results suggest that OCI is not a variant of AS in women. [ncbi.nlm.nih.gov]

  The features are highly suggestive of Osteitis Condensans ilii Case by Dr MGK Murthy, MD, DNB Teaching points: It is predominantly found in women usually after child births. [sumerdoc.blogspot.com]

  The cause and pathogenesis of this entity is unclear and it is suggested that anti-inflammatory agents may be of benefit in certain cases. Full Text [jamanetwork.com]

• Withdrawn

  The cannulated drill bit was advanced over the first wire until it began to enter the sclerosed area, then the wire was withdrawn and thereafter the bit was advanced to enable adequate core decompression. [ncbi.nlm.nih.gov]

• Forgetful

  Among the numerous causes, we must not forget to consider OCI, especially in female patients during the fertile decades. [ncbi.nlm.nih.gov]

• Irritability

  We report an elite swimmer with superficial peroneal neuropathy unassociated with obvious anatomic abnormality and likely related to chronic irritation secondary to kicking activities. [kundoc.com]

The diagnostic criteria of OCI includes [3] [4]:

• Unilateral or more commonly bilateral
• Sclerosis of the lower margin of the iliac bone and a normal sacroiliac joint on radiological imaging
• Predominance in females
• Normal inflammatory parameters
• Negative HLA-B27 antigen
• Normal bone scan
• Absence of bone erosion or destruction

In addition, a thorough history and physical examination can help differentiate OCI from ankylosing spondylitis, sacroiliitis, seronegative spondyloarthropathies, primary hyperparathyroidism, renal osteodystrophy, Paget's disease, bone secondaries and lymphoma [3] [5] [6] [7] [8]. Normal blood tests and seronegativity can exclude most of these conditions.

The radiographical appearance of OCI is described as a well defined triangular sclerosis of the iliac bone in the sacroiliac joint. Eburnation can be observed in the inferior part of the bone. Sclerosis can extend to the auricular portion of the iliac bone. Unlike other forms of sacroiliitis, the joint space is not obliterated in OCI and the articular margins remain intact. The radiological features of OCI can resolve over time [9].

In a small group of patients affected with OCI, polyarthralgia in the peripheral joints has been reported. However, significant inflammatory articular changes are usually absent.

• HLA-B27

  Of the 25 patients with OCI, only 2, 8% were HLA B27 positive compared with 11 of 12 patients with AS, 92%. These results suggest that OCI is not a variant of AS in women. [ncbi.nlm.nih.gov]

After the symptomatic treatment, her symptom was improved. Keywords : Osteitis condensans ilii, Low back pain, Sacroiliitis [jrd.or.kr]

INTERVENTIONS Analgesic treatment. MEASUREMENTS AND MAIN RESULTS We were presented with the history of a woman with low lumbar pain of a mechanical character, after a dystocial birth two months previously. [unboundmedicine.com]

Balancing multiple theoretical approaches and healing paradigms in a diagnostic and treatment context, Alon Marcus offers a sophisticated text for practitioners applying these insights. [books.google.de]

Treatment and prognosis It carries a benign prognosis and may even resolve spontaneously. The main differential diagnoses are sacroiliitis or SI joint osteoarthritis. [radiopaedia.org]

Prognosis in osteitis condensans ilii. Radiology. 1959 Feb;72(2):234-7. Jenks K, Meikle G, Gray A, Stebbings S. Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in women. Int J Rheum Dis. 2009 Apr;12(1):39-43. [roentgenrayreader.blogspot.com]

Prognosis Osteitis condensans ilii (OCI) is associated with chronic lower back pain and sclerotic lesions on the radiographs but it is a self-limiting and nonprogressive disease. [ncbi.nlm.nih.gov]

They found nothing suggesting an etiologic factor. Shipp and Haggart (6) later reviewed this same material and extended the series to cover 100 cases. [pubs.rsna.org]

Introduction Osteitis condensans ilii (OCI) is one of the benign etiologies of chronic axial low back pain. Most of the time, OCI is an incidental finding on plain X-ray with ileal sclerosis. [cureus.com]

Epidemiology of spondyloarthritis: a review. Curr Rheumatol Rep. 2013 Sep;15(9):351. [PubMed: 23888360] 10. Antonelli MJ, Magrey M. Sacroiliitis mimics: a case report and review of the literature. BMC Musculoskelet Disord. 2017 Apr 22;18(1):170. [ncbi.nlm.nih.gov]

His presentation is well gro- ded in the basic sciences and in pathophysiology, an approach which brings a - markable coherence to the text. Correlative imaging concepts are also carefully th- aded through these chapters. [books.google.de]

The pathophysiology of OCI has been described as unknown and the research is vague. It has been postulated that the gravid uterus may compress the abdominal aorta and cause ischemia in the inferior portion of the ilium. [clinicalmaze.com]

Still, the pathophysiology of OCI is not clearly understood, but the increased mechanical stress on ileum is considered one of the causative factor of OCI in pregnant women. [cureus.com]

To have strong bones when you are young, and to prevent bone loss when you are older, you need to get enough calcium, vitamin D, and exercise. You should also avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. [icdlist.com]

Prevention Flexibility in athletes is the most important step toward prevention of osteitis pubis. Proper body mechanics must be stressed in athletes who participate in activities that yield a higher incidence of this condition. [emedicine.medscape.com]

Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive [jamanetwork.com]

1. Vadivelu R, Green TP, Bhatt R. An uncommon cause of back pain in pregnancy. Postgrad. Med. J. 2005;81:65-67.
2. Thompson M. Osteitis Condensans Ilii and its differentiation from Ankylosing Spondylitis. Ann Rheum Dis. 1954;13(2):147-156.
3. Mitra R. Osteitis condensans Ilii. Rheumatol Int. 2010;30(3):293–296.
4. Rodríguez-Pla A, Moreno Muelas JV, Urgell JR, Benach JO, Roldós EA. Osteitis condensans Ilii: a cause of low back pain? A case-controlled, retrospective study. J Musculoskelet Pain. 2004;12(2):65–70.
5. Jenks K, Meikle G, Gray A, Stebbings S. Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in women. Int J Rheum Dis. 2009;12(1):39–43.
6. Cidem M, Capkin E, Karkucak M, Karaca A. Osteitis condensans ilii in differential diagnosis of patients with chronic low back pain: a review of the literature. Mod Rheumatol. 2012;22(3):467–469.
7. Shipp FL, Haggart GE. Further experience in the management of osteitis condensans ilii. J Bone Joint Surg. 1950;32A:841–847.
8. Thompson M, Newton DR, Grainger RG. Discussion of the clinical and radiological aspects of sacro-iliac disease. Proc R Soc Med. 1957;50(10):847–858.
9. Numaguchi Y. Osteitis condensans ilii, including its resolution. Radiology 1971;98:1–8.