Osteitis condensans ilii results in recurrent axial low-back pain. It mostly affects women and is found incidentally on plain X-ray by observing iliac bone sclerosis and a normal sacroiliac joint.
Presentation
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].
Entire Body System
- Weakness
Different kinds of bone problems include Low bone density and osteoporosis, which make your bones weak and more likely to break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also develop cancer and [icdlist.com]
StatPearls will help you identify your weaknesses so that when you are ready to study for a board or certification exam in Radiology-Musculoskeletal, you will already be prepared. [knowledge.statpearls.com]
If there is active severe denervation and weakness on exam then patient may get referred to the spine surgeon to correct the problem, but not all radiculopathies need surgical correction and some improve as disk material can get resorbed ...Read more [healthtap.com]
She had never complained of any numbness or “pins and needles” nor weakness in her legs. She had no history suggestive of morning stiffness or other joint involvement. She had no family history of joint disorders. [pmj.bmj.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]
- Wound Infection
The non-operated asymptomatic side had spontaneous remodelling There were no substantial complications among the studied cases; however, two overweight cases had superficial wound infections. [ncbi.nlm.nih.gov]
- Chronic Infection
The theories regarding the relationship of vascular occlusion, juvenile epiphysitis and chronic infection are discussed. The probable role of pregnancy is considered. Some points in the differential diagnosis are considered. [birpublications.org]
Musculoskeletal
- 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]
- 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]
- Leg Pain
(Level 2B) Characteristics/Clinical Presentation Patients report low back pain (below L5), pain in the buttocks and/or pelvis and postero-lateral on the thigh, which may extend down to one or both legs. [physio-pedia.com]
Psychiatrical
- 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]
Neurologic
- 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]
Workup
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.
Colonoscopy
- Polyps
704 Semispecific Liver Patterns in Cirrhosis 719 Viral Markers of Hepatitis 738 Intravenous Contrast Strategies for Liver Lesions 745 Balthazar CTSeverity Index for Acute Pancreatitis 757 GASTROINTESTINAL TRACT 769 Differential Diagnosis of Colonic Polyps [books.google.de]
Treatment
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]
Prognosis
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]
Etiology
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
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]
Pathophysiology
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]
Prevention
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]
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References
- Vadivelu R, Green TP, Bhatt R. An uncommon cause of back pain in pregnancy. Postgrad. Med. J. 2005;81:65-67.
- Thompson M. Osteitis Condensans Ilii and its differentiation from Ankylosing Spondylitis. Ann Rheum Dis. 1954;13(2):147-156.
- Mitra R. Osteitis condensans Ilii. Rheumatol Int. 2010;30(3):293–296.
- 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.
- 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.
- 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.
- Shipp FL, Haggart GE. Further experience in the management of osteitis condensans ilii. J Bone Joint Surg. 1950;32A:841–847.
- 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.
- Numaguchi Y. Osteitis condensans ilii, including its resolution. Radiology 1971;98:1–8.