Skip to main content
Top
Published in: Skeletal Radiology 12/2011

01-12-2011 | Scientific Article

Proximal iliotibial band syndrome: what is it and where is it?

Authors: Irene Sher, Hilary Umans, Sherry A. Downie, Keith Tobin, Ritika Arora, Todd R. Olson

Published in: Skeletal Radiology | Issue 12/2011

Login to get access

Abstract

Objective

To describe the clinical and MR imaging features of a unique strain at the iliac tubercle enthesis. While this strain appeared to correspond to the iliotibial band (IT band) enthesis, the literature regarding the IT band origin was discrepant. As such, our second goal was to prove that the IT band originated at the iliac tubercle, through cadaveric dissection.

Materials and methods

Three musculoskeletal radiologists prospectively reviewed 67 consecutive bony pelvis MRI studies from October 2006 through September 2008 using either 3, 1.5, or 0.3 T units. Seven cases demonstrating strain at the iliac tubercle enthesis were identified and reviewed by consensus. History and patient demographics were reviewed. Cadaveric dissection was performed to delineate the anatomy of the proximal IT band.

Results

Seven out of 67 individuals, all women, were identified with strain at the level of the iliac tubercle (prevalence 10%). Four of seven were athletes, three were overweight. Patients presented with pain and tenderness at the iliac tubercle. Anatomic dissection confirmed that iliotibial band originates along the margin of the iliac crest with dominant fibers condensing on the iliac tubercle.

Conclusion

Proximal IT band strain represents a unique injury that should be considered in patients who are female athletes or older overweight women who present with pain and tenderness at the iliac tubercle. Imaging of this entity must include the iliac tubercle, which is often excluded in standard hip MRI.
Literature
1.
go back to reference Cvitanic O, Henzie G, Skezas N, Lyons J, Minter J. MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus). AJR Am J Roentgenol. 2004;182:137–43.CrossRefPubMed Cvitanic O, Henzie G, Skezas N, Lyons J, Minter J. MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus). AJR Am J Roentgenol. 2004;182:137–43.CrossRefPubMed
2.
go back to reference Hebert KJ, Laor T, Divine JG, Emery KH, Wall EJ. MRI appearance of chronic stress injury of the iliac crest apophysis in adolescent athletes. AJR Am J Roentgenol. 2008;190:1487–91.CrossRefPubMed Hebert KJ, Laor T, Divine JG, Emery KH, Wall EJ. MRI appearance of chronic stress injury of the iliac crest apophysis in adolescent athletes. AJR Am J Roentgenol. 2008;190:1487–91.CrossRefPubMed
4.
go back to reference Martens M, Libbrecht P, Burssens A. Surgical treatment of the iliotibial band syndrome. Am J Sports Med. 1989;17:651–4.CrossRefPubMed Martens M, Libbrecht P, Burssens A. Surgical treatment of the iliotibial band syndrome. Am J Sports Med. 1989;17:651–4.CrossRefPubMed
5.
go back to reference McNicol K, Traunton JE, Clement DB. Iliotibial tract friction syndrome in athletes. Can J Appl Sports Sci. 1981;6:76–80. McNicol K, Traunton JE, Clement DB. Iliotibial tract friction syndrome in athletes. Can J Appl Sports Sci. 1981;6:76–80.
6.
go back to reference Fredericson M, Weir A. Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. 2006;16(3):261–8.CrossRefPubMed Fredericson M, Weir A. Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. 2006;16(3):261–8.CrossRefPubMed
7.
go back to reference Murphy BJ, Hechtman KS, Uribe JW, Selesnick H, Smith RL, Zlatkin MB. Iliotibial band friction syndrome: MR imaging findings. Radiology. 1992;185:569–71.CrossRefPubMed Murphy BJ, Hechtman KS, Uribe JW, Selesnick H, Smith RL, Zlatkin MB. Iliotibial band friction syndrome: MR imaging findings. Radiology. 1992;185:569–71.CrossRefPubMed
8.
go back to reference Muhle C, Mo Ahn J, Yeh L, et al. Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology. 1999;212:103–10.CrossRefPubMed Muhle C, Mo Ahn J, Yeh L, et al. Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology. 1999;212:103–10.CrossRefPubMed
9.
go back to reference Kaplan E. The iliotibial tract: clinical and morphological significance. J Bone Joint Surg Am. 1958;40:817–32.CrossRefPubMed Kaplan E. The iliotibial tract: clinical and morphological significance. J Bone Joint Surg Am. 1958;40:817–32.CrossRefPubMed
10.
go back to reference Hollinshead WH. Anatomy for surgeons, vol. 3. New York: Harper and Row Hoeber Medical Division; 1964. Hollinshead WH. Anatomy for surgeons, vol. 3. New York: Harper and Row Hoeber Medical Division; 1964.
11.
go back to reference Birnbaum K, Siebert CH, Pandorf T, Schopphoff E, Prescher A, Niethard FU. Anatomic and biomechanical investigations of the iliotibial tract. Surg Radiol Anat. 2004;26:433–46.CrossRefPubMed Birnbaum K, Siebert CH, Pandorf T, Schopphoff E, Prescher A, Niethard FU. Anatomic and biomechanical investigations of the iliotibial tract. Surg Radiol Anat. 2004;26:433–46.CrossRefPubMed
12.
go back to reference Last RJ. Anatomy regional and applied, 5th ed. Edinburgh: Churchill Livingstone; 1972. Last RJ. Anatomy regional and applied, 5th ed. Edinburgh: Churchill Livingstone; 1972.
14.
go back to reference Standring S. Gray's anatomy: the anatomical basis for clinical practice, 39th ed. Elsevier Churchill Livingstone: Edinburgh; 2005. Standring S. Gray's anatomy: the anatomical basis for clinical practice, 39th ed. Elsevier Churchill Livingstone: Edinburgh; 2005.
15.
go back to reference Netter FH. Atlas of human anatomy, 4th ed. Philadelphia: Saunders Elsevier; 2006. Netter FH. Atlas of human anatomy, 4th ed. Philadelphia: Saunders Elsevier; 2006.
16.
go back to reference Agur AMR, Dalley AF. Grant’s atlas of anatomy, 12th ed. New York: Lippincott Williams and Wilkins; 2009. Agur AMR, Dalley AF. Grant’s atlas of anatomy, 12th ed. New York: Lippincott Williams and Wilkins; 2009.
17.
go back to reference Kingzett-Taylor A, Tirman PFJ, Feller J, et al. Tendinosis and tears of gluteus medius and minimus muscles as a cause of hip pain: MR imaging findings. AJR Am J Roentgenol. 1999;173:1123–6.CrossRefPubMed Kingzett-Taylor A, Tirman PFJ, Feller J, et al. Tendinosis and tears of gluteus medius and minimus muscles as a cause of hip pain: MR imaging findings. AJR Am J Roentgenol. 1999;173:1123–6.CrossRefPubMed
18.
go back to reference Godon EJ. Trochanteric bursitis and tendinitis. Clin Orthop. 1961;20:193–202. Godon EJ. Trochanteric bursitis and tendinitis. Clin Orthop. 1961;20:193–202.
19.
go back to reference Ferber R, Davis IM, Williams D Sr. Gender differences in lower extremity mechanics during running. Clin Biomech. 2003;18:350–7.CrossRef Ferber R, Davis IM, Williams D Sr. Gender differences in lower extremity mechanics during running. Clin Biomech. 2003;18:350–7.CrossRef
20.
go back to reference Chumanov ES, Wall-Scheffler C, Heiderscheit BC. Gender differences in walking and running on level and inclined surfaces. Clin Biomech. 2008;23:1260–8.CrossRef Chumanov ES, Wall-Scheffler C, Heiderscheit BC. Gender differences in walking and running on level and inclined surfaces. Clin Biomech. 2008;23:1260–8.CrossRef
Metadata
Title
Proximal iliotibial band syndrome: what is it and where is it?
Authors
Irene Sher
Hilary Umans
Sherry A. Downie
Keith Tobin
Ritika Arora
Todd R. Olson
Publication date
01-12-2011
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 12/2011
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-011-1168-5

Other articles of this Issue 12/2011

Skeletal Radiology 12/2011 Go to the issue