iliotibial band syndrome

Etiology

• generally results from running

Epidemiology

• common
• classically occurs in avid runners who run on uneven terrain

Pathology

• overuse injury
• potential mechanisms
  • friction of the iliotibial band against the lateral femoral condyle
  • compression of the fat & connective tissue deep to the iliotibial band
  • chronic inflammation of the iliotibial band bursa

Clinical manifestations

• knife-like lateral knee pain associated with repetitive movement
• pain at the end of exercise involving knee flexion & extension is an early symptom
• pain may be worse running downhill, walking downstairs, or increasing stride length
• pain with extension of the knee flexed to ~30 degrees or with repeated flexion & extension of supine person's knee with direct pressure applied over the lateral femoral condyle
• positive Noble test
• negative McMurray test
• point tenderness at the lateral femoral condyle
  • point tenderness 2-3 cm proximal to the lateral femoral condyle
• often radiates to the thigh or the hip
• no instability or locking of knee

Radiology

• imaging studies reserved for refractory disease to rule out other etiologies
• x-ray of knee generally normal

Management

• modification of activity
• physical therapy
  • iliotibial band stretching
  • hip abductor strengthening

More general terms

• syndrome

Additional terms

• iliotibial tract (iliotibial band)
• knee pain
• trochanteric bursitis