Osteitis condensans ilii
Osteitis condensans ilii
Description, Causes and Risk Factors:
Symmetric benign osteosclerosis of the portion of the iliac bones adjacent to the sacroiliac joints. Osteitis condensans ilii is a bone sclerosis characterized by nonspecific inflammation, highly dense bone hardening phenomenon, particularly in the ilium by 2/3 of the more obvious, but you do not change the joint space. The disease is 90 percent for middle-aged woman, especially late in the pregnancy, childbirth, and other infections of pelvic cavity.
Osteitis condensans ilii is a benign sclerosis of the ilium that is commonly seen in young women and has an estimated prevalence of between 1.0% to 3%. The condition is thought to be related to pregnancy, althout it can be seen in men and nulliparous women. When related to pregnancy, it is hypothesized that ligamentous laxity at the sacroiliac joints leads to instability and subsequent sclerosis.
While usually an incidental finding, patients with osteitis condensans ilii are more likely to have sacroiliac joint tenderness compared to controls. A high prevalence of back pain has been reported in patients with osteitis condensans ilii, but controlled studies have not been performed, and the association may be coincidental. In other words, a finding of osteitis condensans ilii should not be taken as an explanation of back pain witout excluding other etiologies.
Bone remodeling due to stress induced vascularity across sacroiliac joints is also be the possible causative factor. Similar isolated changes can occur in pubic bones, medial end of clavicle and other sites.
The condition may resolve spontaneously and radiological picture may also change from time to time. Therapy consists of posture correction and active exercises for 6-12 months. A few nonresponsive cases may require sacroiliac fusion surgery.
Symptoms may include:
Pain that comes and goes (intermittent).
Sharp pains or cramping.
Pressure or heaviness deep within your pelvis.
Severe and steady pain.
In addition, you may experience:
Pain while having a bowel movement.
Pain when you sit down.
Pain during intercourse.
Your discomfort may intensify after standing for long periods and may be relieved when you lie down. The pain may be mild and annoying, or it may be so severe that you miss work, can't sleep and can't exercise.
The radiological criteria for diagnosis were: (a) the presence of a homogeneous triangular area of increased density involving the ilium adjacent to the sacroiliac joint and located at the lower border of the articulating surface of the ilium; (b) normal appearing sacroiliac articulating surfaces and joint space; (c) little or no radiologic evidence of involvement of the sacrum; (d) minimal or no spurring at the lower margin of the sacroiliac joint.
Caution must be used in distinguishing osteitis condensans ilii from several other diseases. Probably the condition most resembling it is hypertrophic arthritis of the sacroiliac joint. Here, however, the area of condensation is usually much smaller and is located at the most caudad portion of the sacroiliac joint. The joint space may be narrowed and the typical finding of eburnation with spurring is present. The process also involves the sacrum and it does not improve with time. One should look for a history of injury or other skeletal abnormalities to support this diagnosis.
In the majority of patient, conservative treatment has been employed. The most important single measure has been the correction, where possible, of obvious postural defects. This was accomplished primarily through training in active muscle exercises under the supervision of competent physical therapist. This training was continued until such time as the correct posture could be maintained by the patient without conscious muscular effort, - usually six months to one year. Postural training was further supplemented by reduction of excessive weight, by increased rest and the use of bed board, and occasionally by an adequate corset.”
If the ilium is fractured, there is a chance it could become infected. If this happens, and if the infection resists antibiotics, it is sometimes necessary to undergo surgery. In some cases, part of the ilium is removed, and a tube is placed into the pelvic region and grafted over to hold it in place, which allows the infection to drain from the body.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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