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Osteitis condensans ilii

Osteitis condensans ilii is characterized by benign sclerosis of the ilium adjacent to the sacroiliac joint

Pathology

The underlying etiology is believed to be mechanical stress across the SI joint. The fact that it is most often seen in women who have given birth supports this hypothesis, however also women who have not given birth and men can be affected 2-4

Clinical presentation

It is usually asymptomatic but uncommonly may cause lower back pain, with a frequency about 1-2.5% 4.

Radiographic features

Plain film and CT

Sclerosis of the ilial part of 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 need for further imaging 3. Unilateral disease has also been reported. 

Prognosis

It carries a benign prognosis and may even resolve spontaneously. 

Differential diagnosis

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.

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