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

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Iliotibial band (ITB) = iliotibial tract (ITT)
            • Synonyms

              • ITB friction syndrome, ITB syndrome (ITBS), runner knee
            • Definitions

              • ITBS: overuse injury from friction or pressure between ITB and lateral femoral condyle (LFC)
                • Occurs as response to repetitive overuse injury
              • Lateral synovial recess: incorrect term in some literature for space between ITB and LFC
                • There is no synovium in the space
                • "ITB recess" or "ITB space" may be better term
                • Iliotibial bursa: adventitious (i.e., not anatomic) bursa that may develop with ITBS

            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

                                    • Reporting Tips

                                      Selected References

                                      1. Bolia IK et al: Operative versus nonoperative management of distal iliotibial band syndrome-where do we stand? A systematic review. Arthrosc Sports Med Rehabil. 2(4):e399-415, 2020
                                      2. Flato R et al: The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol. 46(5):605-22, 2017
                                      3. Cowden CH 3rd et al: Arthroscopic treatment of iliotibial band syndrome. Arthrosc Tech. 3(1):e57-60, 2014
                                      4. 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
                                      5. Strauss EJ et al: Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 19(12):728-36, 2011
                                      6. 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
                                      7. 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
                                      8. 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
                                      9. Fredericson M et al: Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. 16(3):261-8, 2006
                                      10. Fredericson M et al: Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 35(5):451-9, 2005
                                      11. Costa ML et al: Knee synovial cyst presenting as iliotibial band friction syndrome. Knee. 11(3):247-8, 2004
                                      12. Farrell KC et al: Force and repetition in cycling: possible implications for iliotibial band friction syndrome. Knee. 10(1):103-9, 2003
                                      13. Kirk KL et al: Iliotibial band friction syndrome. Orthopedics. 23(11):1209-14; discussion 1214-5; quiz 1216-7, 2000
                                      14. 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
                                      15. Bonaldi VM et al: Iliotibial band friction syndrome: sonographic findings. J Ultrasound Med. 17(4):257-60, 1998
                                      16. Murphy BJ et al: Iliotibial band friction syndrome: MR imaging findings. Radiology. 185(2):569-71, 1992
                                      17. 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) = iliotibial tract (ITT)
                                                • Synonyms

                                                  • ITB friction syndrome, ITB syndrome (ITBS), runner knee
                                                • Definitions

                                                  • ITBS: overuse injury from friction or pressure between ITB and lateral femoral condyle (LFC)
                                                    • Occurs as response to repetitive overuse injury
                                                  • Lateral synovial recess: incorrect term in some literature for space between ITB and LFC
                                                    • There is no synovium in the space
                                                    • "ITB recess" or "ITB space" may be better term
                                                    • Iliotibial bursa: adventitious (i.e., not anatomic) bursa that may develop with ITBS

                                                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

                                                                        • Reporting Tips

                                                                          Selected References

                                                                          1. Bolia IK et al: Operative versus nonoperative management of distal iliotibial band syndrome-where do we stand? A systematic review. Arthrosc Sports Med Rehabil. 2(4):e399-415, 2020
                                                                          2. Flato R et al: The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol. 46(5):605-22, 2017
                                                                          3. Cowden CH 3rd et al: Arthroscopic treatment of iliotibial band syndrome. Arthrosc Tech. 3(1):e57-60, 2014
                                                                          4. 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
                                                                          5. Strauss EJ et al: Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 19(12):728-36, 2011
                                                                          6. 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
                                                                          7. 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
                                                                          8. 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
                                                                          9. Fredericson M et al: Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. 16(3):261-8, 2006
                                                                          10. Fredericson M et al: Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 35(5):451-9, 2005
                                                                          11. Costa ML et al: Knee synovial cyst presenting as iliotibial band friction syndrome. Knee. 11(3):247-8, 2004
                                                                          12. Farrell KC et al: Force and repetition in cycling: possible implications for iliotibial band friction syndrome. Knee. 10(1):103-9, 2003
                                                                          13. Kirk KL et al: Iliotibial band friction syndrome. Orthopedics. 23(11):1209-14; discussion 1214-5; quiz 1216-7, 2000
                                                                          14. 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
                                                                          15. Bonaldi VM et al: Iliotibial band friction syndrome: sonographic findings. J Ultrasound Med. 17(4):257-60, 1998
                                                                          16. Murphy BJ et al: Iliotibial band friction syndrome: MR imaging findings. Radiology. 185(2):569-71, 1992
                                                                          17. Noble CA: Iliotibial band friction syndrome in runners. Am J Sports Med. 8(4):232-4, 1980