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Case of the Week 250

What's the most likely diagnosis?

  • 36 year-old mother of four with back pain

  1. Lead poisoning
  2. Ankylosing spondylitis
  3. Osteoblastic bone metastases
  4. Osteitis condensans ilii
  5. Reiter's syndrome



4. Osteitis condensans ilii



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Osteitis condensans ilii

General considerations

  • Benign sclerosis of the iliac side of the sacroiliac joints
  • Bilaterally symmetric
    • Rarely unilateral
  • Radiologic diagnosis discovered serendipitously
  • Usually found in young females who have had several children but also may be seen in males
  • Related to remodeling of bone following stress across the sacroiliac joint
    • Other theories of etiology are that it is related to a urinary tract infection, or that it
    • May be related to a form of inflammatory arthritis
  • Clinical findings
    • Rarely symptomatic but may be mildly painful
    • May have morning stiffness and polyarthralgia


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