Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in women

Abstract

Aim: To determine whether subjects with radiological evidence of osteitis condensans ilii exhibit symptoms and signs in common with sacroiliitis when compared with an age-matched control group and to examine demographic features. Methods:The Dunedin Hospital radiology database was searched for all subjects with changes of osteitis condensans ilii over a 10-year period. An age-matched control group with plain X-rays of the pelvis was recruited from the same database. All subjects were sent a questionnaire enquiring about back pain and details of previous pregnancies. Those who responded to the questionnaire were invited for clinical assessment.Results: Thirty-five individuals with osteitis condensans ilii were identified over the 10-year period. All were female and reported prior pregnancy supporting an association between osteitis condensans ilii and pregnancy. Stress testing of the sacroiliac joints was associated with greater tenderness in the osteitis condensans ilii group with a mean of 1.8 positive tests out of a possible 4, compared to 0.8 in the control group (Wilcoxon ranksum test P = 0.02). 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 Index (BASFI). 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.

Musculoskeletal problems in pregnancy

“…This condition is most commonly observed in women who have had a previous pregnancy, although it can still be observed in nulliparous women [20,21]. The onset of pain is during the pregnancy or the postpartum period.…”

SPECT/CT of Osteitis Condensans Ilii

“…On physical examination, focal tenderness over the sacroiliacal joints and during compression tests can be observed. 5,6 Also patients may have increased lumbar lordosis, moderate obesity, and lumbar extensor muscle spasm. 1 There are no neurologic deficit symptoms or signs.…”

Osteitis condensans ilii may demonstrate bone marrow edema on sacroiliac joint magnetic resonance imaging

“…These results were all comparable with previously reported large series of OCI. [3][4][5]8,14 Four cases (14.8%) were HLA-B27 antigen positive (two cases demonstrating BME and two cases not). This seems higher than most literature reports, but was comparable with Singal et al 4 who reported the distribution of HLA-B27 antigens in a group of 37 female patients; four of the 25 OCI patients (16%) were B27 positive while 11 of 12 ankylosing spondylitis patients (92%) were B27 positive.…”