Stemcelldoc's Weblog

April 19, 2012

Lateral Knee Pain: Iliotibial Band Syndrome

At the Centeno-Schultz Clinic we acknowledge that there are many causes of lateral knee pain.  An important case report was discussed in a previous blogOrtho 2.0 outlines the four key concepts: stabilization, articulation, neurological functions and alignment.

The iliotibial band (ITB) is a longitudinal fibrous reinforcement of one of the lateral leg muscles, the fascia lata.  It  originates from the anterior superior iliac spine region and extends down the lateral portion of the thigh to the knee.

Proximally it inserts into the lateral epicondyle of the femur and then passes to insert distally on the lateral aspect of tibia tubercle (gerdy’s tubercle).

When the knee is extended, the ITB is anterior to the lateral femoral condyle. When the knee is flexed the ITB is posterior to the lateral femoral condyle.

Actions of the iliotibial band include thigh flexion at the hip, abduction, medial rotation and  lateral stabilization the knee.

Iliotibial Band syndrome is an overuse phenomenon which is common in runners.  Typically pain occurs over lateral femoral epicondyle, which is caused by irritation and inflammation of the distal iliotibial band as it rubs against the lateral femoral condyle.

Differential diagnosis includes lateral meniscus tear,  popliteus,tendinitis, and patellofemoral pain syndrome.

The iliotibial band is a standard part of the diagnostic knee ultrasound conducted at the Centeno-Schultz Clinic.  In the ultrasound image below a normal  iliotibial band is identified by the white arrows.

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