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Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome

Year 2022, Volume: 39 Issue: 3, 649 - 653, 30.08.2022

Abstract

Chronic Pelvic Pain (CPP) is defined as severe pain that persists continuously or intermittently for six months or longer in women, is unrelated to sexual intercourse or menstruation, is likely to cause functional limitation, and requires medical treatment. Osteitis Condensans Ilii (OCI) and Pelvic Congestion Syndrome (PCS) are known causes of CPP. Sacroiliac joint Magnetic Resonance Imaging (MRI) can show different clinical mimickers of sacroiliitis and pelvic pain causes such as OCI and PCS. In this study, our aim was to investigate the frequency of OCI and PCS in patients referred to our clinic for Sacroiliac joint MRI due to low back-pelvic pain and to analyze their association with age, presence of sacroiliitis and multiparity. The the data of 700 female patients who attended the hospital with complaints of low back pain were investigated and it was found that the number of births experienced by the patient significantly correlated with OCI (OR:3.3) and PCS (OR:5.1). Even when MRI shows no evidence of sacroiliitis in a multiparous woman admitted with low back pain, these two differential diagnoses should still be considered by clinicians and radiologists.

References

  • Asciutto, G., et al., 2008. MR venography in the detection of pelvic venous congestion. Eur J Vasc Endovasc Surg. 36, 491-6.
  • Beard, R.W., et al., 1984. Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet. 2, 946-9.
  • Biswas, S., et al., 2019. Osteitis Condensans Ilii: An Uncommon Cause of Back Pain. Cureus. 11, e4518.
  • Borghi, C., Dell'Atti, L., 2016. Pelvic congestion syndrome: the current state of the literature. Arch Gynecol Obstet. 293, 291-301.
  • Cheong, Y., William Stones, R., 2006. Chronic pelvic pain: aetiology and therapy. Best Pract Res Clin Obstet Gynaecol. 20, 695-711.
  • Cimsit, C., et al., 2017. Evaluation of sacroiliac joint MRI for pelvic venous congestion signs in women clinically suspected of sacroiliitis. Acta Radiol. 58, 849-855.
  • Coakley, F.V., Varghese, S.L., Hricak, H., 1999. CT and MRI of pelvic varices in women. J Comput Assist Tomogr. 23, 429-34.
  • Ekin, E.E., Yıldız, H.K., 2017. Kronik Pelvik Ağrı Ayırıcı Tanısında Pelvik Venöz Konjesyon. Journal of Academic Research in Medicine. 7.
  • Eshed, I., Lidar, M., 2017. MRI Findings of the Sacroiliac Joints in Patients with Low Back Pain: Alternative Diagnosis to Inflammatory Sacroiliitis. Isr Med Assoc J. 19, 666-669.
  • Giacchetto, C., et al., 1990. Ovarian varicocele: ultrasonic and phlebographic evaluation. J Clin Ultrasound. 18, 551-5.
  • Grace, V.M., Zondervan, K.T., 2004. Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. Aust N Z J Public Health. 28, 369-75.
  • Harris, R.D., Holtzman, S.R., Poppe, A.M., 2000. Clinical outcome in female patients with pelvic pain and normal pelvic US findings. Radiology. 216, 440-3.
  • Jans, L., et al., 2014. MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis. Eur J Radiol. 83, 179-84.
  • Kuligowska, E., Deeds, L., 3rd, Lu, K., 3rd, 2005. Pelvic pain: overlooked and underdiagnosed gynecologic conditions. Radiographics. 25, 3-20.
  • Ma, L., et al., 2018. Osteitis condensans ilii may demonstrate bone marrow edema on sacroiliac joint magnetic resonance imaging. Int J Rheum Dis. 21, 299-307.
  • Mathias, S.D., et al., 1996. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 87, 321-7.
  • Mitra, R., 2010. Osteitis Condensans Ilii. Rheumatol Int. 30, 293-6.
  • Numaguchi, Y., 1971. Osteitis condensans ilii, including its resolution. Radiology. 98, 1-8.
  • Nykoliation, J., Cassidy, J., Dupuis, P., 1984. Osteitis condensans illii—a sacrolliac stress phenomenon: a report of a case. The Journal of the Canadian Chiropractic Association. 28, 209.
  • Park, S.J., et al., 2004. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. AJR Am J Roentgenol. 182, 683-8.
  • Resnick, D., 1995. Disorders of other endocrine glands and of pregnancy. Diagnosis of bone and joint disorders. Philadelphia: WB Saunders. 2089-92.
  • Rudwaleit, M., et al., 2009a. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis. 68, 1520-7.
  • Rudwaleit, M., et al., 2009b. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 68, 777-83.
  • Schwarzer, A.C., Aprill, C.N., Bogduk, N., 1995. The sacroiliac joint in chronic low back pain. Spine (Phila Pa 1976). 20, 31-7.
  • Shelkey, J., et al., 2014. Case report: pelvic congestion syndrome as an unusual etiology for chronic hip pain in 2 active, middle-age women. Sports Health. 6, 145-8.
  • Shipp, F.L., Haggart, G.E., 1950. Further experience in the management of osteitis condensans ILII. J Bone Joint Surg Am. 32 A, 841-7.
  • Sutlive, T.G., et al., 2008. Development of a clinical prediction rule for diagnosing hip osteoarthritis in individuals with unilateral hip pain. J Orthop Sports Phys Ther. 38, 542-50.
  • Thompson, M., 1954. Osteitis condensans ilii and its differentiation from ankylosing spondylitis. Ann Rheum Dis. 13, 147-56.
  • Ude, W.H., 1950. Osteitis condensans illi; the possible relationship to juvenile epiphysitis. J Lancet. 70, 81.
Year 2022, Volume: 39 Issue: 3, 649 - 653, 30.08.2022

Abstract

References

  • Asciutto, G., et al., 2008. MR venography in the detection of pelvic venous congestion. Eur J Vasc Endovasc Surg. 36, 491-6.
  • Beard, R.W., et al., 1984. Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet. 2, 946-9.
  • Biswas, S., et al., 2019. Osteitis Condensans Ilii: An Uncommon Cause of Back Pain. Cureus. 11, e4518.
  • Borghi, C., Dell'Atti, L., 2016. Pelvic congestion syndrome: the current state of the literature. Arch Gynecol Obstet. 293, 291-301.
  • Cheong, Y., William Stones, R., 2006. Chronic pelvic pain: aetiology and therapy. Best Pract Res Clin Obstet Gynaecol. 20, 695-711.
  • Cimsit, C., et al., 2017. Evaluation of sacroiliac joint MRI for pelvic venous congestion signs in women clinically suspected of sacroiliitis. Acta Radiol. 58, 849-855.
  • Coakley, F.V., Varghese, S.L., Hricak, H., 1999. CT and MRI of pelvic varices in women. J Comput Assist Tomogr. 23, 429-34.
  • Ekin, E.E., Yıldız, H.K., 2017. Kronik Pelvik Ağrı Ayırıcı Tanısında Pelvik Venöz Konjesyon. Journal of Academic Research in Medicine. 7.
  • Eshed, I., Lidar, M., 2017. MRI Findings of the Sacroiliac Joints in Patients with Low Back Pain: Alternative Diagnosis to Inflammatory Sacroiliitis. Isr Med Assoc J. 19, 666-669.
  • Giacchetto, C., et al., 1990. Ovarian varicocele: ultrasonic and phlebographic evaluation. J Clin Ultrasound. 18, 551-5.
  • Grace, V.M., Zondervan, K.T., 2004. Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. Aust N Z J Public Health. 28, 369-75.
  • Harris, R.D., Holtzman, S.R., Poppe, A.M., 2000. Clinical outcome in female patients with pelvic pain and normal pelvic US findings. Radiology. 216, 440-3.
  • Jans, L., et al., 2014. MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis. Eur J Radiol. 83, 179-84.
  • Kuligowska, E., Deeds, L., 3rd, Lu, K., 3rd, 2005. Pelvic pain: overlooked and underdiagnosed gynecologic conditions. Radiographics. 25, 3-20.
  • Ma, L., et al., 2018. Osteitis condensans ilii may demonstrate bone marrow edema on sacroiliac joint magnetic resonance imaging. Int J Rheum Dis. 21, 299-307.
  • Mathias, S.D., et al., 1996. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 87, 321-7.
  • Mitra, R., 2010. Osteitis Condensans Ilii. Rheumatol Int. 30, 293-6.
  • Numaguchi, Y., 1971. Osteitis condensans ilii, including its resolution. Radiology. 98, 1-8.
  • Nykoliation, J., Cassidy, J., Dupuis, P., 1984. Osteitis condensans illii—a sacrolliac stress phenomenon: a report of a case. The Journal of the Canadian Chiropractic Association. 28, 209.
  • Park, S.J., et al., 2004. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. AJR Am J Roentgenol. 182, 683-8.
  • Resnick, D., 1995. Disorders of other endocrine glands and of pregnancy. Diagnosis of bone and joint disorders. Philadelphia: WB Saunders. 2089-92.
  • Rudwaleit, M., et al., 2009a. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis. 68, 1520-7.
  • Rudwaleit, M., et al., 2009b. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 68, 777-83.
  • Schwarzer, A.C., Aprill, C.N., Bogduk, N., 1995. The sacroiliac joint in chronic low back pain. Spine (Phila Pa 1976). 20, 31-7.
  • Shelkey, J., et al., 2014. Case report: pelvic congestion syndrome as an unusual etiology for chronic hip pain in 2 active, middle-age women. Sports Health. 6, 145-8.
  • Shipp, F.L., Haggart, G.E., 1950. Further experience in the management of osteitis condensans ILII. J Bone Joint Surg Am. 32 A, 841-7.
  • Sutlive, T.G., et al., 2008. Development of a clinical prediction rule for diagnosing hip osteoarthritis in individuals with unilateral hip pain. J Orthop Sports Phys Ther. 38, 542-50.
  • Thompson, M., 1954. Osteitis condensans ilii and its differentiation from ankylosing spondylitis. Ann Rheum Dis. 13, 147-56.
  • Ude, W.H., 1950. Osteitis condensans illi; the possible relationship to juvenile epiphysitis. J Lancet. 70, 81.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Aysu Başak Özbalcı 0000-0001-9974-5974

Miğraci Tosun 0000-0003-1548-5111

Early Pub Date August 30, 2022
Publication Date August 30, 2022
Submission Date November 13, 2021
Acceptance Date January 5, 2022
Published in Issue Year 2022 Volume: 39 Issue: 3

Cite

APA Özbalcı, A. B., & Tosun, M. (2022). Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome. Journal of Experimental and Clinical Medicine, 39(3), 649-653.
AMA Özbalcı AB, Tosun M. Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome. J. Exp. Clin. Med. August 2022;39(3):649-653.
Chicago Özbalcı, Aysu Başak, and Miğraci Tosun. “Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome”. Journal of Experimental and Clinical Medicine 39, no. 3 (August 2022): 649-53.
EndNote Özbalcı AB, Tosun M (August 1, 2022) Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome. Journal of Experimental and Clinical Medicine 39 3 649–653.
IEEE A. B. Özbalcı and M. Tosun, “Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome”, J. Exp. Clin. Med., vol. 39, no. 3, pp. 649–653, 2022.
ISNAD Özbalcı, Aysu Başak - Tosun, Miğraci. “Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome”. Journal of Experimental and Clinical Medicine 39/3 (August 2022), 649-653.
JAMA Özbalcı AB, Tosun M. Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome. J. Exp. Clin. Med. 2022;39:649–653.
MLA Özbalcı, Aysu Başak and Miğraci Tosun. “Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome”. Journal of Experimental and Clinical Medicine, vol. 39, no. 3, 2022, pp. 649-53.
Vancouver Özbalcı AB, Tosun M. Causes of Parity-Related Pelvic Pain Found Incidentally on Sacroiliac Joint MRI: Osteitis Condensans Ilii and Pelvic Congestion Syndrome. J. Exp. Clin. Med. 2022;39(3):649-53.