iliotibial band syndrome

Question 1

what is the iliotibial band/tract?

Answer 1

a branch of longitudinal fibres that form the shared aponeurosis of tensor fasciae latae and the gluteus maximus.

Inflammation of this band results in the condition termed iliotibial band syndrome

Question 2

what is the most common cause of lateral knee pain in athletes?

Answer 2

Iliotibial band syndrome is the most common cause of lateral knee pain in athletes

Question 3

where does the iliotibial band attach too?

Answer 3

extends from the iliac tubercle to the anterolateral tubercle of the tibia

Question 4

what are the risk factors?

Answer 4

common in those who have regular exercise involving repetitive flexion and extension of the knee, commonly runners, weightlifters, or cyclists

Anatomical risk factors include genu varum, excessive internal tibial torsion, foot pronation, and hip abductor weakness.

Question 5

what are the clinical features of iliotibial band syndrome?

Answer 5

• lateral knee pain
• exacerbated by exercise
• asses for history of any previous trauma (more suggestive of ligamentous knee injury) or any features of OA

Question 6

what are your differentials?

Answer 6

degenerative joint disease, fractures, and ligamentous injury (especially following a history of trauma and relevant findings on examination)

Question 7

what investigations can be done into ILTBS?

Answer 7

diagnosis of iliotibial band syndrome can be made clinically.

Imaging, such as plain radiograph or MRI imaging, can be used to exclude other pathology, if the history and examination are not conclusive.

Question 8

how is ILTBS managed generally?

Answer 8

Most patients can be advised to modify their activity accordingly and use of regular simple analgesics during periods of acute pain.

Longer-term management can often include local steroid injections, in aid to reduce localised inflammation, and physiotherapy

Question 9

how is ILTBS managed surgically?

Answer 9

Surgery is only indication if patients remain symptomatic or functionally limited after 6 months, despite all other non-medical treatment.

Surgical management involves release of the iliotibial band from its attachments from the patella, allowing for a greater range of movement.