Osteitis condensans ilii is characterised by benign sclerosis of the ilium adjacent to the sacroiliac (SI) joint, typically bilateral and triangular in shape.
It is usually asymptomatic but uncommonly may cause lower back pain, with a frequency about 1-2.5% 4.
The underlying aetiology is believed to be mechanical stress across the SI joint. That it is most often seen in women who have given birth supports this hypothesis, however, women who have not given birth and men can be affected 2-4.
Plain radiograph and CT
Sclerosis of the ilial part of the sacroiliac joint is seen, typically bilateral and triangular in shape 3-4. Lack of involvement of sacrum or joint space narrowing is considered diagnostic and thus, may obviate the need for further imaging 3. Unilateral disease has also been reported.
Treatment and prognosis
It carries a benign prognosis and may even resolve spontaneously.
The main differential diagnosis is a sacroiliitis, but with osteitis condensans ilii the SI joint is normal with no irregularity, erosions or loss of joint space.
- 1. Dähnert W. Radiology review manual. Lippincott Williams & Wilkins. (2007) ISBN:0781738954. Read it at Google Books - Find it at Amazon
- 2. HUTTON CF. Osteitis condensans ilii. Br J Radiol. 1953;26 (309): 490-3. doi:10.1259/0007-1285-26-309-490 - Pubmed citation
- 3. Mitra R. Osteitis Condensans Ilii. Rheumatol. Int. 2010;30 (3): 293-6. doi:10.1007/s00296-009-1100-7 - Pubmed citation
- 4. Cidem M, Capkin E, Karkucak M et-al. Osteitis condensans ilii in differential diagnosis of patients with chronic low back pain: a review of the literature. Mod Rheumatol. 2012;22 (3): 467-9. doi:10.1007/s10165-011-0513-9 - Pubmed citation
- 5. Gemmel F, de Coningh Av, Collins J et-al. SPECT/CT of osteitis condensans ilii: one-stop shop imaging. Clin Nucl Med. 2011;36 (1): 59-61. doi:10.1097/RLU.0b013e3181feefe8 - Pubmed citation
- 6. Olivieri I, Gemignani G, Camerini E et-al. Differential diagnosis between osteitis condensans ilii and sacroiliitis. J. Rheumatol. 1991;17 (11): 1504-12. Pubmed citation
- 7. Jenks K, Meikle G, Gray A et-al. Osteitis condensans ilii: a significant association with sacroiliac joint tenderness in women. Int J Rheum Dis. 2009;12 (1): 39-43. doi:10.1111/j.1756-185X.2009.01378.x - Pubmed citation