Iliotibial Band

In 1917, Groves reported the use of a proximally based strip of iliotibial band that was passed through drill holes in the lateral femoral condyle and proximal tibia to substitute for the tom ACL. Thereafter, multiple modifications to his technique developed. Cho was the first to describe a distally based... 

FIG. 65-1 PINS sacrum and pelvis point patterns. Posterior I, piriformis muscle 2, Iliotibial band 3, sciatic nerve/ posterior femoral cutaneous nerve/hamstrtng muscles 4, gluteal muscles 5, sacroiliac. 

The iliotibial band along the lateral thigh is often tender, which may indicate undue tension of the tissues between the hip and knee. 

Next, every effort should be made to localize the pain as precisely as possible because this can provide useful information to target the US examination. As a general rule, diffuse knee pain derives from joint lesions, whereas more localized pain is more commonly related to tendon involvement and local disorders. Information on the character, duration and location of pain is extremely helpful in the evaluation of tendinitis. In jumper s knee , for instance, the patient typically reports pain over the most proximal portion of the patellar tendon, just behind the tip of the patella. Runners complaining of lateral knee pain and tenderness should be questioned for signs of tendinitis affecting the distal insertion of the biceps femoris and the iliotibial band, so-called runner s knee . In the event of soft-tissue lumps or indeterminate swelling around the... 

The lateral aspect of the knee joint is examined by asking the patient to rotate the leg internally. From anterior to posterior, the structures to be evaluated are the distal aspect of the iliotibial band, the external femorotibial joint space with the lateral meniscus, the lateral collateral ligament, the popliteus tendon and the superior tibiofibular joint. 

The distal segment of the iliotibial band is best imaged on long-axis scans. If doubts exist as to whether the probe is correctly oriented, one should consider that the iliotibial band is located between the anterior and middle third of the lateral aspect... 

Lateral knee pain is a common clinical challenge that may be secondary to a variety of soft-tissue and intra-articular disorders. US is able to provide clinically useful information to identify injuries of the lateral collateral ligament and the iliotibial band as well as meniscal cysts. In addition, it can give a full depiction of ganglion cysts arising from the... 

At the level of its distal third, the iliotibial band contacts the lateral aspect of the lateral femoral condyle, moving forward in extension and backward in flexion. At this site, a synovial bursa intervening between these structures helps to decrease local attrition during movements of the knee joint. During sporting activities, and particularly after... 

Fig. 14.76a-d. Iliotibial band friction syndrome, a Coronal split-screen and b transverse 12-5 MHz US images over the lateral knee with correlative c coronal and d transverse fat-suppressed T2-weighted MR images demonstrate fusiform hypoechoic swelling of the distal iliotibial band (white arrowhead) as it courses over the lateral femoral condyle as a result of impingement. Note that the distal part of the band has a normal echotexture (open arrowhead). A hypoanechoic area (arrow) located between the band and the condyle reflects a fluid collection within the synovial bursa... 

---