Iliac Bone Osteitis

　　Pathogenesis

　　The etiology is unknown and may be related to pregnancy, trauma, infection, and overuse. During childbirth, the stability of the sacroiliac joint is affected, the surrounding ligaments become relaxed, and the abnormal stress on the iliac bone itself and the local joint increases; in addition, the inclination angle of the sacrum increases, the pelvis tilts forward and downward, and the traction of the ligaments attached to the iliac bone affects the blood supply of the iliac bone, causing local blood supply to decrease and leading to dense changes in the bone.

　　Osteitis pubis is most commonly associated with chronic, persistent pain in the lower lumbar region, which can radiate to the buttocks and posterior thigh, but without obvious root pain symptoms. Later X-rays show ossification of the iliac bone surface, but no bone destruction. However, as osteitis pubis is a self-limiting disease, it does not damage the sacrum, and there are no reports of other complications in clinical practice.

　　The main symptoms are pain in the lumbar sacral or lower lumbar region, occasionally radiating pain to the lower part of the buttocks and the back of the thigh, but it does not belong to the radicular pain radiating to the lower limb. The patient has a plump figure and a large sacral angle, and the sacrospinalis muscle is often in a tense state. The pelvis separation test and the '4' test are positive, the patient's erythrocyte sedimentation rate is normal, and there is no bacterial inflammatory manifestation.

　　The prevention of Iliac Bone Osteitis starts with the prevention of boils, sores, carbuncles, and upper respiratory tract infections. At the same time, attention should be paid to maintaining air circulation in the living environment, paying attention to environmental hygiene and personal hygiene, strengthening physical exercise, and enhancing physical fitness. In addition, it is also necessary to prevent traumatic infections, try to discover and treat infections as early as possible. Pay attention to the maintenance of daily diet and improve the quality of life, appropriate calcium supplementation.

　　The main finding is that the iliac cortical bone near the joint surface shows a spondylotic change on X-ray plain films, the bone is dense, located below 1/2 of the sacroiliac joint, and mostly triangular; the sacroiliac joint space is regular and clear, and there are no signs of destruction of the joint surface and bone. It is more common on one side, but there are also bilateral cases.

　　In general, there is no need for CT and MRI examinations for this disease, but exceptions are made for those who need to be differentiated from tumors and other lesions.

　　Iliac Bone Osteitis patients should eat more foods high in calcium, avoid contact with toxic substances and radiation sources, quit smoking, drinking, and tea, prevent colds, and avoid spicy foods. The patient's diet should be light and easy to digest, eat more vegetables and fruits, properly match the diet, and pay attention to adequate nutrition. In addition, the patient should also pay attention to avoid spicy, greasy, and cold foods.

　　The main treatment is non-surgical. For those with mild symptoms, it is appropriate to rest in bed and use an elastic belt to protect after getting out of bed; for those with severe symptoms, painkillers can be taken and a brace can be used for protection, and the patient is encouraged to do abdominal muscle exercises after the pain subsides, and continue to use an elastic waistband for protection. For those with refractory pain, consider surgery to fuse the sacroiliac joint.