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Iliotibial Band Friction Syndrome
Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Iliotibial band (ITB)
            • Synonyms

              • ITB friction syndrome, ITB syndrome, runner knee
            • Definitions

              • Chronic inflammatory response to friction between ITB and lateral femoral condyle (LFC)
                • Occurs as response to repetitive overuse injury
              • Lateral synovial recess (LSR): Adventitial bursa at superolateral knee joint
                • Lies between ITB and LFC
                • Confusing terminology: LSR lies outside joint fluid within true lateral recess of joint proper
                • If fluid collection develops in LSR, may call it iliotibial bursitis

            IMAGING

            • General Features

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Cowden CH 3rd et al: Arthroscopic treatment of iliotibial band syndrome. Arthrosc Tech. 3(1):e57-60, 2014
                                    2. Grando H et al: MR imaging of extrasynovial inflammation and impingement about the knee. Magn Reson Imaging Clin N Am. 22(4):725-41, 2014
                                    3. Strauss EJ et al: Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 19(12):728-36, 2011
                                    4. Hariri S et al: Treatment of recalcitrant iliotibial band friction syndrome with open iliotibial band bursectomy: indications, technique, and clinical outcomes. Am J Sports Med. 37(7):1417-24, 2009
                                    5. Vasilevska V et al: Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee. Skeletal Radiol. 38(9):871-5, 2009
                                    6. Fairclough J et al: The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. 208(3):309-16, 2006
                                    7. Fredericson M et al: Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. 16(3):261-8, 2006
                                    8. Fredericson M et al: Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 35(5):451-9, 2005
                                    9. Costa ML et al: Knee synovial cyst presenting as iliotibial band friction syndrome. Knee. 11(3):247-8, 2004
                                    10. Farrell KC et al: Force and repetition in cycling: possible implications for iliotibial band friction syndrome. Knee. 10(1):103-9, 2003
                                    11. Kirk KL et al: Iliotibial band friction syndrome. Orthopedics. 23(11):1209-14; discussion 1214-5; quiz 1216-7, 2000
                                    12. Muhle C et al: Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology. 212(1):103-10, 1999
                                    13. Bonaldi VM et al: Iliotibial band friction syndrome: sonographic findings. J Ultrasound Med. 17(4):257-60, 1998
                                    14. Murphy BJ et al: Iliotibial band friction syndrome: MR imaging findings. Radiology. 185(2):569-71, 1992
                                    15. Noble CA: Iliotibial band friction syndrome in runners. Am J Sports Med. 8(4):232-4, 1980
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Iliotibial band (ITB)
                                              • Synonyms

                                                • ITB friction syndrome, ITB syndrome, runner knee
                                              • Definitions

                                                • Chronic inflammatory response to friction between ITB and lateral femoral condyle (LFC)
                                                  • Occurs as response to repetitive overuse injury
                                                • Lateral synovial recess (LSR): Adventitial bursa at superolateral knee joint
                                                  • Lies between ITB and LFC
                                                  • Confusing terminology: LSR lies outside joint fluid within true lateral recess of joint proper
                                                  • If fluid collection develops in LSR, may call it iliotibial bursitis

                                              IMAGING

                                              • General Features

                                                • MR Findings

                                                  • Ultrasonographic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Cowden CH 3rd et al: Arthroscopic treatment of iliotibial band syndrome. Arthrosc Tech. 3(1):e57-60, 2014
                                                                      2. Grando H et al: MR imaging of extrasynovial inflammation and impingement about the knee. Magn Reson Imaging Clin N Am. 22(4):725-41, 2014
                                                                      3. Strauss EJ et al: Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 19(12):728-36, 2011
                                                                      4. Hariri S et al: Treatment of recalcitrant iliotibial band friction syndrome with open iliotibial band bursectomy: indications, technique, and clinical outcomes. Am J Sports Med. 37(7):1417-24, 2009
                                                                      5. Vasilevska V et al: Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee. Skeletal Radiol. 38(9):871-5, 2009
                                                                      6. Fairclough J et al: The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. 208(3):309-16, 2006
                                                                      7. Fredericson M et al: Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. 16(3):261-8, 2006
                                                                      8. Fredericson M et al: Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 35(5):451-9, 2005
                                                                      9. Costa ML et al: Knee synovial cyst presenting as iliotibial band friction syndrome. Knee. 11(3):247-8, 2004
                                                                      10. Farrell KC et al: Force and repetition in cycling: possible implications for iliotibial band friction syndrome. Knee. 10(1):103-9, 2003
                                                                      11. Kirk KL et al: Iliotibial band friction syndrome. Orthopedics. 23(11):1209-14; discussion 1214-5; quiz 1216-7, 2000
                                                                      12. Muhle C et al: Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology. 212(1):103-10, 1999
                                                                      13. Bonaldi VM et al: Iliotibial band friction syndrome: sonographic findings. J Ultrasound Med. 17(4):257-60, 1998
                                                                      14. Murphy BJ et al: Iliotibial band friction syndrome: MR imaging findings. Radiology. 185(2):569-71, 1992
                                                                      15. Noble CA: Iliotibial band friction syndrome in runners. Am J Sports Med. 8(4):232-4, 1980