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Osteitis condensans ilii: current knowledge and diagnostic approach

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Abstract

Osteitis condensans ilii is a noninflammatory condition of an uncertain etiology, characterized by sclerotic bone lesions located mainly in the iliac region of the sacroiliac joints. In many patients, osteitis condensans ilii remains an incidental imaging finding; however, it has been associated with lower back pain and may mimic inflammatory rheumatic conditions such as axial spondyloarthritis. The diagnosis is based on the presence of the characteristic sclerotic lesions on radiographs and the exclusion of other conditions that are associated with back pain. Management is usually conservative with the use of physical therapy and analgesics, and it is associated with a favorable prognosis. Herein, we conducted a narrative literature review using the terms osteitis condensans ilii, and we identified case reports, case series, reviews, and original studies associated with the condition. The aim of this article is to raise the awareness of this underrecognized clinicoradiological condition and to enable the health-care providers to recognize clinical and radiological features that should raise suspicion of the osteitis condensans illi, and to describe the treatment options.

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References

  1. Thompson M (1954) Osteitis condensans ilii and its differentiation from ankylosing spondylitis. Ann Rheum Dis 13:147–156. https://doi.org/10.1136/ard.13.2.147

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Sicard JA, Gally L, Haguenau J (1926) Osteites condensantes, a etiologie inconnue. J Radiol D’electrol 10:503–507

    Google Scholar 

  3. Barsony T, Polgar F (1928) Osteitis Condensans Ilei: ein bisher nicht beschriebernes Krankheitsbild. Fortschr Rontgenstrahlen 37:663–669

    Google Scholar 

  4. Cidem M, Capkin E, Karkucak M, Karaca A (2012) Osteitis condensans ilii in differential diagnosis of patients with chronic low back pain: a review of the literature. Mod Rheumatol 22:467–469. https://doi.org/10.1007/s10165-011-0513-9

    Article  PubMed  Google Scholar 

  5. Williams PM, Byerly DW (2020) Osteitis condensans ilii. In: StatPearls. StatPearls Publishing. Treasure Island (FL). https://www.ncbi.nlm.nih.gov/books/NBK551569/. Accessed 11 Dec 2019

  6. Berent F (1933) Beiträge zur Pathologie der Kreuz Darmbeinfugen. Arch orthop Unfallchir 32:642–651

    Google Scholar 

  7. Numaguchi Y (1971) Osteitis condensans ilii, including its resolution. Radiology 98:1–8. https://doi.org/10.1148/98.1.1

    Article  CAS  PubMed  Google Scholar 

  8. Mitra R (2010) Osteitis condensans ilii. Rheumatol Int 30:293–296. https://doi.org/10.1007/s00296-009-1100-7

    Article  PubMed  Google Scholar 

  9. Jans L, Van Praet L, Elewaut D et al (2014) MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis. Eur J Radiol 83:179–184. https://doi.org/10.1016/j.ejrad.2013.10.001

    Article  CAS  PubMed  Google Scholar 

  10. Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD (2011) Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 31(11):1409–1417. https://doi.org/10.1007/s00296-011-1999-3

    Article  PubMed  Google Scholar 

  11. Shipp FL, Haggart GE (1950) Further experience in the management of Osteitis condensans ilii. J Bone Jt Surg Am 32:841–847

    Article  Google Scholar 

  12. Ude WH (1950) Osteitis condensans illi; the possible relationship to juvenile epiphysitis. J Lancet 70:81

    CAS  PubMed  Google Scholar 

  13. Hutton CF (1953) Osteitis condensans ilii. Br J Radiol 26:490–493. https://doi.org/10.1259/0007-1285-26-309-490

    Article  CAS  PubMed  Google Scholar 

  14. Jenks K, Meikle G, Gray A, Stebbings S (2009) Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in women. Int J Rheum Dis 12:39–43. https://doi.org/10.1111/j.1756-185X.2009.01378.x

    Article  PubMed  Google Scholar 

  15. Tuite MJ (2008) Sacroiliac joint imaging. Semin Musculoskelet Radiol 12:72–82. https://doi.org/10.1055/s-2008-1067939

    Article  PubMed  Google Scholar 

  16. Resnick D (2002) Diagnosis of bone and joint disorders, 4th edn. WB Saunders, Philadelphia

    Google Scholar 

  17. Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH (2012) The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat 221:537–567. https://doi.org/10.1111/j.1469-7580.2012.01564.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Segal G, Kellogg DS (1954) Osteitis condensans ilii. Am J Roentgenol Radium Ther Nucl Med 71:643–649

    CAS  PubMed  Google Scholar 

  19. Jacqueline F, Arlet J (1959) Osteitis condensans ilii; a comparison with the acetabular condensation observed in cases of osteoarthritis secondary to subluxation of the hip. Arthritis Rheum 2:8–15. https://doi.org/10.1002/1529-0131(195902)2:1%3c8:aid-art1780020103%3e3.0.co;2-3

    Article  CAS  PubMed  Google Scholar 

  20. Gillespie HW (1953) Osteitis condensans. Br J Radiol 26:16–21. https://doi.org/10.1259/0007-1285-26-301-16

    Article  CAS  PubMed  Google Scholar 

  21. Rendich RA, Shapiro AV (1936) Osteitis condensans ilii. J Bone Jt Surg 18:899–908

    Google Scholar 

  22. Hare HF, Haggart GE (1945) Osteitis condensans ilii. JAMA 128:723–727

    Article  Google Scholar 

  23. Olivieri I, Ferri S, Barozzi L (1996) Osteitis condensans ilii. Br J Rheumatol 35:295–297. https://doi.org/10.1093/rheumatology/35.3.295-a

    Article  CAS  PubMed  Google Scholar 

  24. Singal DP, de Bosset P, Gordon DA, Smythe HA, Urowitz MB, Koehler BE (1977) HLA antigens in osteitis condensans ilii and ankylosing spondylitis. J Rheumatol Suppl 3:105–108

    CAS  PubMed  Google Scholar 

  25. Clarke DP, Higgins JN, Valentine AR, Black C (1994) Magnetic resonance imaging of osteitis condensans ilii. Br J Rheumatol 33:599–600. https://doi.org/10.1093/rheumatology/33.6.599

    Article  CAS  PubMed  Google Scholar 

  26. Eshed I, Lidar M (2017) MRI findings of the sacroiliac joints in patients with low back pain: alternative diagnosis to inflammatory sacroiliitis. Isr Med Assoc J 19:666–669

    PubMed  Google Scholar 

  27. Ma L, Gao Z, Zhong Y, Meng Q (2018) Osteitis condensans ilii may demonstrate bone marrow edema on sacroiliac joint magnetic resonance imaging. Int J Rheum 21:299–307. https://doi.org/10.1111/1756-185X.13125

    Article  Google Scholar 

  28. Eshed I, Miloh-Raz H, Dulitzki M et al (2015) Peripartum changes of the sacroiliac joints on MRI: increasing mechanical load correlating with signs of edema and inflammation kindling spondyloarthropathy in the genetically prone. Clin Rheumatol 34:1419–1426. https://doi.org/10.1007/s10067-015-2976-0

    Article  PubMed  Google Scholar 

  29. Gemmel F, de Coningh Av, Collins J, Rijk P (2011) SPECT/CT of osteitis condensans ilii: one-stop shop imaging. Clin Nucl Med 36:59–61. https://doi.org/10.1097/RLU.0b013e3181feefe8

    Article  PubMed  Google Scholar 

  30. Lee YC, Chen KY, Chiu JS, Kao CH, Hung GU (2012) FDG uptake in sacroiliac joint due to osteitis condensans ilii shown on PET/CT in a patient with breast cancer: the value of coregistered CT in avoiding misinterpretation. Clin Nucl Med 37:e121–123. https://doi.org/10.1097/RLU.0b013e31824c5d60

    Article  PubMed  Google Scholar 

  31. Kenzaka T, Kamada M (2019) Osteitis condensans ilii. Intern Med 58:899–900. https://doi.org/10.2169/internalmedicine.1264-18

    Article  PubMed  Google Scholar 

  32. Parhami N, DiGiacomo R, Jouzevicius JL (1988) Metastatic bone lesions of leiomyosarcoma mimicking osteitis condensans ilii. J Rheumatol 15:1035–1037

    CAS  PubMed  Google Scholar 

  33. Strand V, Rao SA, Shillington AC, Cifaldi MA, McGuire M, Ruderman EM (2013) Prevalence of axial spondyloarthritis in United States rheumatology practices: assessment of SpondyloArthritis International Society criteria versus rheumatology expert clinical diagnosis. Arthritis Care Res (Hoboken) 65:1299–1306. https://doi.org/10.1002/acr.21994

    Article  Google Scholar 

  34. Knutsson F (1950) Changes in the sacroiliac joints in morbus Bechterew and osteitis condensans. Acta radiol 33:557–569. https://doi.org/10.3109/00016925009174898

    Article  CAS  PubMed  Google Scholar 

  35. Ralston SH (2013) Clinical practice. Paget’s disease of bone. N Engl J Med 368:644–650. https://doi.org/10.1056/NEJMcp1204713

    Article  CAS  PubMed  Google Scholar 

  36. Antonelli MJ, Magrey M (2017) Sacroiliitis mimics: a case report and review of the literature. BMC Musculoskelet Disord 18:170. https://doi.org/10.1186/s12891-017-1525-1

    Article  PubMed  PubMed Central  Google Scholar 

  37. Vadivelu R, Green TP, Bhatt R (2005) An uncommon cause of back pain in pregnancy. Postgrad Med J 81:65–67. https://doi.org/10.1136/pgmj.2003.015370

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Ayoub MA (2013) Refractory osteitis condensans ilii: outcome of a novel mini-invasive surgical approach. Int Orthop 37:1251–1256. https://doi.org/10.1007/s00264-013-1901-x

    Article  PubMed  PubMed Central  Google Scholar 

  39. Servodio Iammarrone C, Grillo G, Lalla E, Fazioli F (1989) L’osteite condensante dell’ileo: Problemi di diagnosi e terapia. Contributo casistico [Osteitis condensans ilii: therapy and diagnostic problems. Presentation of a case study]. Chir Organi Mov 74:101–107

    CAS  PubMed  Google Scholar 

  40. Withrington RH, Sturge RA, Mitchell N (1985) Osteitis condensans ilii or sacroiliitis? Scand J Rheumatol 14:163–166. https://doi.org/10.3109/030097458509165498

    Article  CAS  PubMed  Google Scholar 

  41. Isley JK Jr, Baylin GJ (1959) Prognosis in osteitis condensans ilii. Radiology 72:234–237. https://doi.org/10.1148/72.2.234

    Article  PubMed  Google Scholar 

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Funding

No specific funding was received from any bodies in the public, commercial or not-for-profit sectors to carry out the work described in this manuscript.

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Authors and Affiliations

  1. University of Arizona College of Medicine, 475 N 5th Street, Phoenix, AZ, USA

    Konstantinos Parperis

  2. Division of Rheumatology, Department of Internal Medicine, University of Cyprus Medical School, Nicosia, Cyprus

    Konstantinos Parperis

  3. Division of Rheumatology, Nicosia General Hospital, Nicosia, Cyprus

    Savvas Psarelis

  4. Centre for Rheumatic Diseases, King’s College London, London, UK

    Elena Nikiphorou

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  1. Konstantinos Parperis
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  2. Savvas Psarelis
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  3. Elena Nikiphorou
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In accordance with the ICMJE criteria, all the authors contributed to the conception of the work, data acquisition, analysis and interpretation. All the authors contribute to draft, critically review and revise the manuscript and approve the final version of manuscript to be published. All co-authors take full responsibility for the integrity of the review.

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Correspondence to Konstantinos Parperis.

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Parperis, K., Psarelis, S. & Nikiphorou, E. Osteitis condensans ilii: current knowledge and diagnostic approach. Rheumatol Int 40, 1013–1019 (2020). https://doi.org/10.1007/s00296-020-04582-9

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