Osteitis Condensans Ilii and Acetabular Labral Tear after Pregnancy: A Case Report

Case Report

Phys Med Rehabil Int. 2015;2(5): 1049.

Osteitis Condensans Ilii and Acetabular Labral Tear after Pregnancy: A Case Report

Mittal V1,2, Miller JE2,3 and Kohler MJ2,4*

1Department of Orthopaedic Surgery, Massachusetts General Hospital, USA

2Harvard Medical School, USA

3Department of Physical Medicine and Rehabilitation,Spaulding Rehabilitation Hospital, USA

4Division of Rheumatology, Allergy, Immunology,Massachusetts General Hospital, USA

*Corresponding author: Kohler MJ, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, USA

Received: April 14, 2015; Accepted: June 08, 2015; Published: June 10, 2015


Low back and hip pain are common musculoskeletal complaints. Due to its reported low prevalence, osteitis condensans illi (OCI) is not always considered in the differential diagnosis for low back or hip pain and is often difficult to distinguish based on symptoms alone. OCI is often diagnosed by imaging and is characterized by sclerosis of the ilium with an otherwise normal sacroiliac joint that can be seen in post-partum patients. It can be easily confused for sacroiliitis, spondyloarthropathies, and metastatic bone lesions. This is the case of a 35 year old woman with a 5-year history of right hip pain which began after her first pregnancy who was diagnosed with OCI and additional acetabular labral tear. We report the defining clinical and imaging features of OCI to help guide clinicians in diagnosing and managing this condition.

Keywords: Hip pain; Osteitis condensans ilii; Spondyloarthropathy; Sacroiliitis; Labral tear


OCI: Osteitis Condensans Illii; SpA: Spondyloarthropathy

Case Presentation

A 35-year-old woman presented to rheumatology clinic with a 5-year history of chronic right hip pain which began after her first pregnancy without prior trauma, injury, or infection. She reported 5/10 pain radiating down the front of the right leg and occasionally into the groin region, as well as lateral hip and sacroiliac (SI) joint pains. Walking, weight bearing, and transitional movements worsened the pain; standing improved it. Acetaminophen provided modest pain control. She denied prolonged morning stiffness, rash, joint swelling, and denied family history of inflammatory disease.

Physical exam revealed right-sided tenderness at the SI joint and greater trochanter regions. Right hip/groin pain was elicited with external or internal rotation beyond 10 degrees and with straight leg raise. FABER (flexion, abduction, external rotation of ipsilateral hip) and gluteus medius strength testing were unable to be performed secondary to pain. Neurologic testing of the lower extremities was normal. There was no lumbar bony vertebral or paraspinal muscle tenderness, and range of motion of the spine was normal.

MRI revealed an anterosuperior labral tear of the right hip and edema adjacent to the inferior aspect of the iliac side of the sacroiliac joints bilaterally (Figure 1). The latter corresponded with areas of sclerosis seen on a prior abdominal CT, and radiology reported these image findings to be consistent with bilateral osteitis condensans ilii.