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Magnetic Resonance Imaging of Iliotibial Band Syndrome

Department of Orthopaedic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina

Thomas Pope, MD

Department of Orthopaedic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina

David F. Martin, MD

Department of Orthopaedic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina

Walton W. Curl, MD

Department of Orthopaedic Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina

Seven cases of iliotibial band syndrome and the patho anatomic findings of each, as demonstrated by mag netic resonance imaging, are presented. These findings were compared with magnetic resonance imaging scans of 10 age- and sex-matched control knees with out evidence of lateral knee pain. Magnetic resonance imaging signal consistent with fluid was seen deep to the iliotibial band in the region of the lateral femoral epicondyle in five of the seven cases. Additionally, when compared with the control group, patients with iliotibial band syndrome demonstrated a significantly thicker ili otibial band over the lateral femoral epicondyle (P < 0.05). Thickness of the iliotibial band in the disease group was 5.49 ± 2.12 mm, as opposed to 2.52 ± 1.56 mm in the control group. Cadaveric dis sections were performed on 10 normal knees to further elucidate the exact nature of the area under the iliotibial band. A potential space, i.e., a bursa, was found between the iliotibial band and the knee capsule. This series suggests that magnetic resonance imag ing demonstrates objective evidence of iliotibial band syndrome and can be helpful when a definitive diag nosis is essential. Furthermore, correlated with ana tomic dissection, magnetic resonance imaging identi fies this as a problem within a bursa beneath the iliotibial band and not a problem within the knee joint.

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