Osteitis condensans ilii is characterized 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 etiology is believed to be mechanical stress across the sacroiliac joint. That it is most often seen in women who have given birth supports this hypothesis; however, men and nulliparous women can be affected 2-4.
Plain radiograph and CT
Sclerosis of the iliac side of the sacroiliac joint is seen, typically bilateral, symmetrical and triangular in shape 3,4. Lack of sacral involvement or joint space narrowing is considered diagnostic and thus, may obviate the need for further imaging 3. Unilateral disease has 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 itself 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
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- 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