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Iliotibial Band Friction Syndrome

Case Detail

Anatomy: Musculoskeletal
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 9 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: MR
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14 year old male with knee pain with running.

Case Images


Iliotibial Band Friction Syndrome and Discoid Lateral Meniscus


MR – T1 hypointensity and T2 hyperintensity deep to the iliotibial band. Also note the enlarged lateral meniscus.


Iliotibial band friction syndrome is a common cause of lateral knee pain related to intense physical activity typically in long distance runners and cyclists. Clinically, tenderness is elicited during application of pressure over the lateral femoral condyle during flexion and extension maneuvers. MR however is helpful to differentiate from other etiologies of lateral pain including lateral meniscus tear, lateral collateral injury, and strain of the popliteus or hamstring muscles.

The iliotibial band (ITB) is attached to the supracondylar tubercle of the lateral femoral condyle and the intermuscular septum and continues distally to Gerdy’s tubercle of the anterior proximal tibia. The ITB moves forward in extension and backwards in flexion; the ITB provides lateral stabilization along with the lateral collateral ligament and popliteus muscle in flexion.

Bursal inflammation results from friction of the ITB against the lateral femoral epicondyle during flexion. On MR, fluid accumulation and/or edema medial to the ITB with infiltration of the fatty layer distal to the vastus lateralis.


Muhle C, Ahn JM, Yeh L, et al. Iliotibial band friction syndrome: MR findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology 1999; 212:103-110.

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