Clustered Occurrence of Osteitis Condensans Ilii in Patients with Symptomatic Hip Dysplasia

Maximilian Muellner; Katharina Ziegeler; Torsten Diekhoff; Henryk Haffer; Friederike Schömig; Vincent Justus Leopold; Matthias Pumberger; Friedemann Göhler

doi:10.3390/diagnostics13101701

Clustered Occurrence of Osteitis Condensans Ilii in Patients with Symptomatic Hip Dysplasia

Diagnostics (Basel). 2023 May 11;13(10):1701. doi: 10.3390/diagnostics13101701.

Authors

Maximilian Muellner¹, Katharina Ziegeler², Torsten Diekhoff², Henryk Haffer¹, Friederike Schömig¹, Vincent Justus Leopold¹, Matthias Pumberger¹, Friedemann Göhler²

Affiliations

¹ Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany.
² Department of Radiology, Charité-University Medicine Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany.

Abstract

Background: Osteitis condensans ilii (OCI) is a relatively rare benign disease of the lower anterior sacroiliac joint (SIJ) region that can cause symptoms such as low back pain (LBP), lateral hip pain and nonspecific hip or thigh pain. Its exact pathoetiology remains to be clarified. The aim of this study is to determine the prevalence of OCI in patients with symptomatic developmental dysplasia of the hip (DDH) undergoing periacetabular osteotomy (PAO) to identify potential clustering of OCI in a with altered biomechanics of hip and SIJs.

Methods: A retrospective investigation of all patients who underwent periacetabular osteotomy in a tertiary reference hospital from January 2015 to December 2020. Clinical and demographic data were retrieved from the hospital's internal medical records. Radiographs and magnetic resonance images (MRIs) were reviewed for the presence of OCI. A t-test for independent variables was conducted to identify differences between patients with and without OCI. A binary logistic regression model was established to determine the influence of age, sex and body mass index (BMI) on the presence of OCI.

Results: The final analysis included 306 patients (81% female). In 21.2% of the patients (f: 22.6%; m: 15.5%), OCI was present. BMI was significantly higher in patients with OCI (23.7 kg/m² vs. 25.0 kg/m²; p = 0.044). Binary logistic regression revealed that a higher BMI increased the likelihood of sclerosis in typical osteitis condensans locations, OR = 1.104 (95%-CI [1.024, 1.191]), as did female sex, OR = 2.832 (95%-CI [1.091, 7.352].

Conclusions: Our study revealed a considerably higher prevalence of OCI in patients with DDH than in the general population. Furthermore, BMI was shown to have an influence on the occurrence of OCI. These results support the theory that OCI is attributable to altered mechanical loading of the SIJs. Clinicians should be aware that OCI is common in patients with DDH and a potential cause of LBP, lateral hip pain and nonspecific hip or thigh pain.

Keywords: arthroplasty; developmental dysplasia of the hip; low back pain; sacroiliac joint.

Grants and funding

None of the authors report funding by organizations that may gain or lose financially through the publication of this manuscript. Outside the submitted work, K.Z. reports funding (research grant) from the Assessment of SpondyloArthritis International Society (ASAS) during the conduct of this study. T.D. reports funding (research grant) from the Berlin Institute of Health and Canon Medical Systems; he also reports lecture fees from Canon Medical, UCB, Biocad and Novartis Pharma outside the submitted work and is part of the advisory board of Eli Lilly. F.S. reports funding from the AO Spine Discovery and Innovation Award during the conduct of this study. For all other authors, no funding was reported.