Bone marrow oedema of the sacroiliac joint without spondyloarthritis: a retrospective study of 34 cases of osteitis condensans ilii.

IF 2.1 Q3 RHEUMATOLOGY

Rheumatology Advances in Practice Pub Date : 2025-09-16 eCollection Date: 2025-01-01 DOI:10.1093/rap/rkaf108

Sabine Guehery, Julian Plenard, François Lafourcade, Franck Lapegue, Laurent Zabraniecki, Arnaud Constantin, Nicolas Sans, Adeline Ruyssen Witrand, Marie Faruch Bilfeld

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Abstract

Objective: To determine the prevalence of bone marrow oedema (BME) in osteitis condensans ilii (OCI) on MRI of the sacroiliac joint (SIJ). Secondary objectives include comparisons of socio-demographic characteristics, prevalence of other imaging features (MRI, CT scan), and low back pain in patients with OCI with those in a sex- and age-matched control group.

Methods: A total of 34 patients with OCI, including 29 with MRI, were recruited for retrospective analysis. The SIJ MRIs were retrospectively analysed by two readers. A sex- and age-matched control group of patients without SIJ disorders was included. In both groups, the presence of structural bone abnormalities was assessed by CT scan analysis, and socio-demographic data were obtained by telephone questionnaire. A longitudinal analysis was conducted on patients who had undergone multiple imaging examinations.

Results: All patients were female with a mean age of 34 years. BME was observed in 66% (19/29) of OCI patients. BME in OCI was mainly located in the anterior-middle quadrant (43.48%). OCI patients had significantly more than one delivery (P = 0.0094, McNemar test), even if OCI was found in four nulliparous patients (15%). OCI patients experienced significantly more pain (P = 0.0026, McNemar test).

Conclusion: OCI is an entity found in both pregnant and non-pregnant young women. SIJ BME was found in two-thirds of OCI patients. OCI is a significant cause of BME and should be carefully considered by clinicians when dealing with a patient with low back pain in order to avoid misdiagnosing spondyloarthritis in the presence of BME of the SIJ.

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无脊柱关节炎的骶髂关节骨髓水肿：34例髂凝性骨炎的回顾性研究。

目的：通过骶髂关节（SIJ） MRI检查，了解髂凝骨性炎（OCI）患者骨髓水肿（BME）的发生率。次要目的包括比较OCI患者与性别和年龄匹配对照组的社会人口统计学特征、其他影像学特征（MRI、CT扫描）的患病率和腰痛。方法：对34例OCI患者进行回顾性分析，其中29例行MRI检查。两位读者回顾性分析了SIJ核磁共振成像。一个性别和年龄相匹配的无SIJ障碍患者的对照组被纳入。在两组中，通过CT扫描分析评估骨结构异常的存在，并通过电话问卷调查获得社会人口学数据。对接受多次影像学检查的患者进行纵向分析。结果：所有患者均为女性，平均年龄34岁。66%（19/29）的OCI患者出现BME。OCI的BME主要位于前中象限（43.48%）。即使在4例（15%）未产患者中发现了OCI， OCI患者也有明显多于一次分娩（P = 0.0094， McNemar检验）。OCI患者疼痛明显加重（P = 0.0026， McNemar检验）。结论：OCI在年轻孕妇和非孕妇中均存在。在三分之二的OCI患者中发现SIJ BME。OCI是BME的重要原因，临床医生在治疗腰痛患者时应仔细考虑，以避免在SIJ存在BME时误诊脊柱炎。

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