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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 [4], 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 [1]
- positive Noble test
- negative McMurray test
- point tenderness at the lateral femoral condyle
- often radiates to the thigh or the hip
- no instability or locking of knee [5]
Radiology:
- imaging studies reserved for refractory disease to rule out other etiologies
- x-ray of knee generally normal [5]
Management:
- modification of activity
- physical therapy
- iliotibial band stretching
- hip abductor strengthening
Related
iliotibial tract (iliotibial band)
knee pain
trochanteric bursitis
General
syndrome
References
- Medical Knowledge Self Assessment Program (MKSAP) 15, 18, 19.
American College of Physicians, Philadelphia 2009, 2018, 2021
- Strauss EJ, Kim S, Calcei JG, Park D.
Iliotibial band syndrome: evaluation and management.
J Am Acad Orthop Surg. 2011 Dec;19(12):728-36.
PMID: 22134205
- NEJM Knowledge+ Question of the Week. Aug 6, 2019
https://knowledgeplus.nejm.org/question-of-week/697/
- Pegrum J, Self A, Hall N.
Iliotibial band syndrome.
BMJ 2019 Mar 21; 364:l980
PMID: 30898786
- NEJM Knowledge+