An uncommon cause of back pain in pregnancy

Abstract

Back pain is a major cause of disability worldwide. A case of a 29 year old Caucasian woman with low back pain secondary to an uncommon benign condition called osteitis condensans ilii is presented and the literature is reviewed. Limited information in the literature combined with poor awareness across the specialty and among the primary care physicians leads to an extensive investigation and misdiagnosis of this benign condition. This report emphasis the salient features and the differential diagnosis in diagnosing and managing this rare condition.

Osteitis condensans ilii in differential diagnosis of patients with chronic low back pain: a review of the literature

“…Although its etiology is unclear, various hypotheses have been proposed, the most widely accepted being the mechanical stress hypothesis. The fact that the disease is more commonly observed among patients who have given birth supports this hypothesis, though it can also be seen in women who have not given birth and in men [2]. Radiologically, triangular sclerosis on the iliac surface of bilateral sacroiliac joints is typical [3].…”

“…In that case, use must be made of laboratory parameters. Although there have been rare reports of high inflammation parameters, these are generally within normal limits [2]. The absence of joint erosion and bridging in the sacroiliac joint among X-ray findings and the presence of other X-ray findings of SpA are significant.…”

Sacroiliac joint pathologies in low back pain

“…X-ray with normal ESR and non-inflammatory nature of back pain [12,28]. During pregnancy, SIJ pain can occur from increased weight, excessive lordotic posture and hormone related laxity of ligaments [4,5].…”

Musculoskeletal problems in pregnancy

“…This condition is most commonly observed in women who have had a previous pregnancy, although it can still be observed in nulliparous women [20,21]. The onset of pain is during the pregnancy or the postpartum period.…”