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Iliotibial Band Friction Syndrome: MR Imaging Findings in 16 Patients and MR Arthrographic Study of Six Cadaveric Knees¹

¹ From the Depts of Radiology (C.M., J.M.A., L.R.Y., D.J.T., D.R.) and Pathology (P.H.), Veterans Affairs Medical Center, 3350 La Jolla Village Dr, San Diego, CA 92161; Dept of Diagnostic Radiology, University of Kiel, Germany (C.M.); Dept of Radiology, Stanford University, Calif (G.A.B.); Dept of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (R.D.B.); Dept of Radiology, Thomas Jefferson Hospital, Philadelphia, Pa (M.S.); and Dept of Diagnostic Radiology, Henry Ford Hospital, Detroit, Mich (J.A.J.). Received May 1, 1998; revision requested Jul 6; final revision received Jan 22, 1999; accepted Jan 27. Supported in part by the Deutsche Forschungsgemeinschaft and Veterans Administration grant SA360. Address reprint requests to D.R.

PURPOSE: To define magnetic resonance (MR) imaging findings in patients with the iliotibial band friction syndrome (ITBFS) and to correlate these findings with anatomic features defined at magnetic resonance (MR) arthrography in cadavers.

MATERIALS AND METHODS: The anatomic relationship of the iliotibial tract (ITT) to the lateral recesses of the knee joint and the lateral femoral epicondyle was investigated with MR arthrography at full extension and at 30° and 60° of knee flexion in six cadaveric knees. Seventeen MR imaging studies in 16 patients with ITBFS were evaluated.

RESULTS: In the cadaveric study, no interference of the lateral synovial recess with the lateral femoral epicondyle at full extension and at 30° and 60° of knee flexion was observed. In all specimens, correlation of MR images with macroscopic and microscopic sections revealed no primary bursa between the lateral femoral epicondyle and the ITT. In clinical studies, MR imaging findings of poorly defined signal intensity abnormalities or circumscribed fluid collections were located in a compartmentlike space confined laterally by the ITT and medially by the meniscocapsular junction, the lateral collateral ligament, and the lateral femoral epicondyle.

CONCLUSION: MR imaging accurately depicts the compartmentlike distribution of signal intensity abnormalities in patients with ITBFS.

Index terms: Athletic injuries, 452.485 • Iliotibial tract, 452.92 • Joints, MR, 452.121411, 452.121412, 452.121415 • Knee, injuries, 452.485 • Knee, ligaments, menisci, and cartilage, 452.485, 452.92 • Knee, MR, 452.121411, 452.121412, 452.121415 • Magnetic resonance (MR), arthrography, 452.122

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