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      Osteitis Condensans Ilii: A Case Series

      case-report
      1 , 1 , , 1 , 1
      ,
      Cureus
      Cureus
      incidental, bone marrow edema syndrome, sacroiliitis, ankylosing spondylitis, osteitis condensans ilii

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          Abstract

          Osteitis condensans ilii (OCI) is a rare self-limiting low back pain syndrome. It is an incidental imaging discovery around sacroiliac joints with distinctive sclerotic lesions. We present three case reports as a series. In the first case, a 38-year-old female presented with unresolved chronic low back pain for eight years. She had bilateral triangular sclerosis of the ilium abutting sacroiliac joints and other causes of back pain were ruled out. Non-operative management was successful. In the second case, a 38-year-old female presented with acute exacerbation of low back pain for one year. She suffered low back pain during her pregnancy and postpartum period 16 years ago and intermittently after that. Bilateral radiodensity around sacroiliac joints was noted in the radiograph and she had successful remission with non-operative management. In the third case, a 45-year-old female presented with chronic low back for six years. On radiographs, she had bilateral sclerotic lesions around sacroiliac joints and responded well to non-operative management. OCI is a benign, idiopathic cause of axial low back pain. It is a diagnosis of exclusion and the pelvic radiographs classically show areas of sclerosis in the ilium adjacent to sacroiliac joints bilaterally. Treatment for OCI is essentially non-operative.

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          Osteitis Condensans Ilii.

          Raj Mitra (2010)
          Osteitis Condensans Ilii (OCI) is a benign cause of axial low back pain. Although no clear etiology has been identified, the prevailing theory is that mechanical strain affects the auricular portion of the ilium and causes premature arthritis. The location of the sclerosis has been traditionally confined to the ilium and may give the false impression of sacro-iliac joint involvement. Clinicians must be guided by history, radiographic findings, and laboratory studies in differentiating OCI with other disorders; furthermore additional causes of low back pain including metastatic disease and ankylosing spondylitis must be ruled out. Treatments for the condition are primarily conservative (therapies, non-steroidal anti-inflammatory medications, and steroid injections), with surgical resection being reserved for refractory cases.
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            Osteitis condensans ilii may demonstrate bone marrow edema on sacroiliac joint magnetic resonance imaging.

            To reveal whether bone marrow edema (BME) may appear with osteitis condensans ilii (OCI) on sacroiliac joint (SIJ) magnetic resonance imaging (MRI) and to evaluate the characteristics of BME demonstrated with OCI.
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              Sacroiliitis mimics: a case report and review of the literature

              Background Radiographic sacroiliitis is the hallmark of ankylosing spondylitis (AS), and detection of acute sacroiliitis is pivotal for early diagnosis of AS. Although radiographic sacroiliitis is a distinguishing feature of AS, sacroiliitis can be seen in a variety of other disease entities. Case presentation We present an interesting case of sacroiliitis in a patient with Paget disease; the patient presented with inflammatory back pain which was treated with bisphosphonate. This case demonstrates comorbidity with Paget disease and possible ankylosing spondylitis. We also present a review of the literature for other cases of Paget involvement of the sacroiliac joint. Conclusions In addition, we review radiographic changes to the sacroiliac joint in classical ankylosing spondylitis as well as other common diseases. We compare and contrast features of other diseases that mimic sacroiliitis on a pelvic radiograph including Paget disease, osteitis condensans ilii, diffuse idiopathic skeletal hyperostosis, infections and sarcoid sacroiliitis. There are some features in the pelvic radiographic findings which help distinguish among mimics, however, one must also rely heavily on extra-pelvic radiographic lesions. In addition to the clinical presentation, various nuances may incline a clinician to the correct diagnosis; rheumatologists should be familiar with the imaging differences among these diseases and classic spondylitis findings. Electronic supplementary material The online version of this article (doi:10.1186/s12891-017-1525-1) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                Cureus
                Cureus
                2168-8184
                Cureus
                Cureus (Palo Alto (CA) )
                2168-8184
                18 August 2022
                August 2022
                : 14
                : 8
                : e28152
                Affiliations
                [1 ] Department of Orthopaedics, All India Institute of Medical Sciences, Bibinagar, IND
                Author notes
                Article
                10.7759/cureus.28152
                9482677
                36148199
                2aea66f3-e00c-4d68-a5ea-cd1eaf2edffd
                Copyright © 2022, Sathu et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 18 August 2022
                Categories
                Orthopedics

                incidental,bone marrow edema syndrome,sacroiliitis,ankylosing spondylitis,osteitis condensans ilii

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