Share:
Share this content in WeChat
X
Clinical Article
MRI features of sacroiliac joint bone marrow fat-saturated T2WI high signal in osteitis condensans ilii
LIU Chaoran  LI Wenjuan  ZHU Yunfei  HE Xiaojun  ZHANG Ke  HONG Guobin 

Cite this article as: LIU C R, LI W J, ZHU Y F, et al. MRI features of sacroiliac joint bone marrow fat-saturated T2WI high signal in osteitis condensans ilii[J]. Chin J Magn Reson Imaging, 2023, 14(6): 52-58. DOI:10.12015/issn.1674-8034.2023.06.008.


[Abstract] Objective To explore the features and rules of sacroiliac joint bone marrow fat-saturated T2WI (T2WI-FS) high signal in osteitis condensans ilii (OCI) and axial spondyloarthritis (ax-SpA).Materials and Methods Twenty-three female patients diagnosed with OCI and thirty-four female patients diagnosed with ax-SpA between January 2017 and December 2021 were retrospectively enrolled. The incidence and imaging features of sacroiliac joint bone marrow T2WI-FS high signal were assessed, with a particular focus on the characteristics such as location, range, shape, and signal intensity.Results Compared with the ax-SpA group, the overall incidence of high T2WI-FS signal in the sacroiliac joint was lower in the OCI group [56.5% (13/23) vs. 85.3% (29/34); χ2=5.857, P=0.016]. The incidence of high T2WI-FS signal in the bilateral sacroiliac joint was also lower [26.1% (6/23) vs. 55.9% (19/34); χ2=4.946, P=0.026]. However, there was no significant difference in the incidence of high T2WI-FS signal in unilateral sacroiliac joint [30.4% (7/23) vs. 29.4% (10/34); χ2=0.007, P=0.934]. There were no significant differences between the OCI group and the ax-SpA group in terms of the side, upper/lower part, quadrant and medial margin of high signal distribution in the sacroiliac joint (P>0.05). In terms of morphology, the OCI group mainly exhibited a ribbon-like shape, while the ax-SpA group mainly showed a flaky morphology, and the difference was statistically significant (P<0.001). The high signal range and signal intensity of sacroiliac joint T2WI-FS were also statistically significant between the OCI group and the ax-SpA group (P<0.001). However, there were no significant differences in the high signal range and intensity of T2WI-FS between the sacral and iliac sides, superior and inferior parts, and among quadrants in the OCI group (P>0.05).Conclusions Sacroiliac joint bone marrow T2WI-FS high signal can be seen in OCI, which is usually presented as a small ribbon adjacent to the sclerotic margin with slightly high signal, and contributes to the differential diagnosis of bone marrow edema associated with ax-SpA.
[Keywords] osteitis condensans ilii;axial spondyloarthritis;sacroiliac joint;magnetic resonance Imaging

LIU Chaoran   LI Wenjuan   ZHU Yunfei   HE Xiaojun   ZHANG Ke   HONG Guobin*  

Department of Radiology, Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai 519000, China

Corresponding author: Hong GB, E-mail: honggb@mail.sysu.edu.cn

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 82272104); The Science, Technology Project in the Social Development Field of Zhuhai City (No. ZH22036201210066PWC); Clinical research IIT project of the Fifth Affiliated Hospital of Sun Yat-sen University (No. YNZZ2020-06).
Received  2022-09-02
Accepted  2023-06-09
DOI: 10.12015/issn.1674-8034.2023.06.008
Cite this article as: LIU C R, LI W J, ZHU Y F, et al. MRI features of sacroiliac joint bone marrow fat-saturated T2WI high signal in osteitis condensans ilii[J]. Chin J Magn Reson Imaging, 2023, 14(6): 52-58. DOI:10.12015/issn.1674-8034.2023.06.008.

[1]
AYOUB M A. Refractory osteitis condensans ilii: outcome of a novel mini-invasive surgical approach[J]. International Orthopaedics (SICOT), 2013, 37(7): 1251-1256. DOI: 10.1007/s00264-013-1901-x.
[2]
MITRA R. Osteitis condensans ilii[J]. Rheumatol Int, 2010, 30(3): 293-296. DOI: 10.1007/s00296-009-1100-7.
[3]
PARPERIS K, PSARELIS S, NIKIPHOROU E. Osteitis condensans ilii: current knowledge and diagnostic approach[J]. Rheumatol Int, 2020, 40(7): 1013-1019. DOI: 10.1007/s00296-020-04582-9.
[4]
JANS L, VAN PRAET L, ELEWAUT D, et al. MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis[J]. Eur J Radiol, 2014, 83(1): 179-184. DOI: 10.1016/j.ejrad.2013.10.001.
[5]
MA L, GAO Z H, ZHONG Y, et al. Osteitis condensans ilii may demonstrate bone marrow edema on sacroiliac joint magnetic resonance imaging[J]. Int J Rheum Dis, 2018, 21(1): 299-307. DOI: 10.1111/1756-185X.13125.
[6]
SHEIKH S, JAVED U, BAIG M A. Thinking of unilateral osteitis condensans ilii in the emergency room: case of a young pregnant female with back pain[J]. J Coll Physicians Surg Pak, 2020, 30(12): 1343-1344. DOI: 10.29271/jcpsp.2020.12.1343.
[7]
MAKSYMOWYCH W P, LAMBERT R G, ØSTERGAARD M, et al. MRI lesions in the sacroiliac joints of patients with spondyloarthritis: an update of definitions and validation by the ASAS MRI working group[J]. Ann Rheum Dis, 2019, 78(11): 1550-1558. DOI: 10.1136/annrheumdis-2019-215589.
[8]
OTOMO K, TAKEUCHI T. Osteitis condensans ilii in a patient with ulcerative colitis: a mimic of ankylosing spondylitis or non-radiographic axial spondyloarthritis[J]. Mod Rheumatol Case Rep, 2021, 5(2): 241-245. DOI: 10.1080/24725625.2020.1857041.
[9]
KHAN A, NIGAR A, MOHAMMED F, et al. A rare cause of postpartum back ache: osteitis condensans ilii[J]. J Obstet Gynecol India, 2022, 72(2): 406-408. DOI: 10.1007/s13224-022-01705-z.
[10]
SATHU S, LAKKIREDDY M, KUMAR R, et al. Osteitis condensans ilii: a case series[J/OL]. Cureus, 2022: 14(8): e28152 [2023-06-04]. https://www.cureus.com/articles/108692-osteitis-condensans-ilii-a-case-series#!/ DOI: 10.7759/cureus.28152.
[11]
AUNG T T, SIVA C. Osteitis condensans ilii[J/OL]. J Clin Rheumatol, 2023, 29(3): e14 [2023-06-04]. https://journals.lww.com/jclinrheum/Citation/2023/04000/Osteitis_Condensans_Ilii__An_Important_Mimic_of.12.aspx. DOI: 10.1097/rhu.0000000000001944.
[12]
PODDUBNYY D, WEINECK H, DIEKHOFF T, et al. Clinical and imaging characteristics of osteitis condensans ilii as compared with axial spondyloarthritis[J]. Rheumatology (Oxford), 2020, 59(12): 3798-3806. DOI: 10.1093/rheumatology/keaa175.
[13]
AGTEN C A, ZUBLER V, ZANETTI M, et al. Postpartum bone marrow edema at the sacroiliac joints may mimic sacroiliitis of axial spondyloarthritis on MRI[J]. Am J Roentgenol, 2018, 211(6): 1306-1312. DOI: 10.2214/ajr.17.19404.
[14]
WEBER U, LAMBERT R G W, ØSTERGAARD M, et al. The diagnostic utility of magnetic resonance imaging in spondylarthritis: an international multicenter evaluation of one hundred eighty-seven subjects[J]. Arthritis Rheum, 2010, 62(10): 3048-3058. DOI: 10.1002/art.27571.
[15]
WEBER U, JURIK A G, ZEJDEN A, et al. Frequency and anatomic distribution of magnetic resonance imaging features in the sacroiliac joints of young athletes[J]. Arthritis Rheumatol, 2018, 70(5): 736-745. DOI: 10.1002/art.40429.
[16]
SEVEN S, ØSTERGAARD M, MORSEL-CARLSEN L, et al. Anatomic distribution of sacroiliac joint lesions on magnetic resonance imaging in patients with axial spondyloarthritis and control subjects: a prospective cross-sectional study, including postpartum women, patients with disc herniation, cleaning staff, runners, and healthy individuals[J]. Arthritis Care Res (Hoboken), 2021, 73(5): 742-754. DOI: 10.1002/acr.24473.
[17]
ÇIDEM M, CAPKIN E, KARKUCAK M, et al. Osteitis condensans ilii in differential diagnosis of patients with chronic low back pain: a review of the literature[J]. Mod Rheumatol, 2012, 22(3): 467-469. DOI: 10.1007/s10165-011-0513-9.
[18]
VLEEMING A, SCHUENKE M D, MASI A T, et al. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications[J]. J Anat, 2012, 221(6): 537-567. DOI: 10.1111/j.1469-7580.2012.01564.x.
[19]
EGUND N, SØRENSEN F B, ØSTGÅRD R, et al. CT-guided transarticular biopsy of the sacroiliac joint: technique and histomorphological results. A preliminary study[J].Skeletal Radiol, 2020, 49(3): 453-460. DOI: 10.1007/s00256-019-03305-x.
[20]
USMANI S, AHMED N, KANDARI F AL. 18F-sodium fluoride PET/CT findings in osteitis condensans ilii[J/OL]. Clin Nucl Med, 2020, 46(4): e203-e205 [2023-06-04]. https://journals.lww.com/nuclearmed/Abstract/2021/04000/18F_Sodium_Fluoride_PET_CT_Findings_in_Osteitis.28.aspx. DOI: 10.1097/rlu.0000000000003371.
[21]
PODDUBNYY D, LISTING J, SIEPER J. Brief report: course of active inflammatory and fatty lesions in patients with early axial spondyloarthritis treated with infliximab plus naproxen as compared to naproxen alone: results from the infliximab As first line therapy in patients with early acti[J]. Arthritis Rheumatol, 2016, 68(8): 1899-1903. DOI: 10.1002/art.39690.
[22]
WEBER U, PEDERSEN S J, ZUBLER V, et al. Fat infiltration on magnetic resonance imaging of the sacroiliac joints has limited diagnostic utility in nonradiographic axial spondyloarthritis[J]. J Rheumatol, 2014, 41(1): 75-83. DOI: 10.3899/jrheum.130568.
[23]
SONG I H, HERMANN K G, HAIBEL H, et al. Inflammatory and fatty lesions in the spine and sacroiliac joints on whole-body MRI in early axial spondyloarthritis—3-Year data of the ESTHER trial[J]. Semin Arthritis Rheum, 2016, 45(4): 404-410. DOI: 10.1016/j.semarthrit.2015.08.005.
[24]
GILLESPIE H W. Osteitis condensans[J]. Br J Radiol, 1953, 26(301): 16-21. DOI: 10.1259/0007-1285-26-301-16.
[25]
BORLANDELLI E, CIAFFI J, FESTUCCIA G, et al. Osteitis condensans ilii: prevalence and characteristics of a neglected mimic of sacroiliitis[J].Clin Rheumatol, 2022, 41(2): 483-490. DOI: 10.1007/s10067-021-05925-y.
[26]
JIANG Y P, LI W J, ZHAN Y Y, et al. The value of MAGiC short T1 inversion recovery sequence in the detection of bone marrow edema in sacroiliitis[J]. Chin J Radiol, 2021, 55(1): 59-63. DOI: 10.3760/cma.j.cn112149-20200313-00386.
[27]
ZHAN Y Y, ZHANG K, ZHENG J, et al. Quantitative parameters of MR compilation sequence for evaluation on axial spondyloarthritis sacroiliac joint disease[J]. Chin J Med Imaging Technol, 2021, 37(8): 1214-1218. DOI: 10.13929/j.issn.1003-3289.2021.08.024.
[28]
TESTINI V, EUSEBI L, GUERRA F S, et al. The promising role of DECT in the diagnosis of Osteitis Condensans Ilii: a case report[J/OL]. Acta Biomed, 2023, 94(S1): e2023071 [2023-06-04]. https://pubmed.ncbi.nlm.nih.gov/36883662/. DOI: 10.23750/abm.v94iS1.13900.

PREV Value of radiomics stacking ensemble learning model based on T2WI and CE-T1WI in predicting the efficacy of HIFU ablation of uterine fibroid
NEXT MRS combined with subtraction technique in the prediction of high grade glioma radiomics grading
  



Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn