Skip to main content
Log in

The iliotibial band in acute knee trauma: patterns of injury on MR imaging

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To delineate the spectrum of knee injuries associated with sprains and tears of the distal iliotibial band (ITB).

Materials and methods

A retrospective review of 200 random MRI scans undertaken for acute knee trauma was performed. Scans were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery, or significant artefact. In each scan, the ITB was scored as normal, minor sprain (grade 1), severe sprain (grade 2), and torn (grade 3). The menisci, ligaments, and tendons of each knee were also assessed.

Results

The mean age was 27.4 years (range, 9–69 years) and 71.5 % (n = 143) of the patients were male. The ITB was injured in 115 cases (57.5 %). The next most common soft tissue structure injured was the anterior cruciate ligament (ACL) in 53.5 % of cases (n = 107). Grade 1 ITB injury was seen in 90 of these 115 cases (45 %), grade 2 injury in 20 cases, and grade 3 injury in only five cases. There is a significant association between ITB injury and ACL rupture (p < 0.05), as well as acute patellar dislocation (p < 0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1 %).

Conclusions

ITB injury is common in acute knee trauma and is associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury, and patellar dislocation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Bollen S. Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med. 2000;34(3):227–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. McNally EG. Magnetic resonance imaging of the knee. BMJ. 2002;325(7356):115–6.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Gage BE, McIlvain NM, Collins CL, Fields SK, Comstock RD. Epidemiology of 6.6 million knee injuries presenting to United States emergency departments from 1999 through 2008. Acad Emerg Med Off J Soc Acad Emerg Med. 2012;19(4):378–85.

    Google Scholar 

  4. Flandry F, Hommel G. Normal anatomy and biomechanics of the knee. Sports Med Arthrosc Rev. 2011;19(2):82–92.

    Article  Google Scholar 

  5. Hayes CW, Brigido MK, Jamadar DA, Propeck T. Mechanism-based pattern approach to classification of complex injuries of the knee depicted at MR imaging. Radiograph Rev Publ Radiol Soc N Am, Inc. 2000;20 Spec No: S121–34.

  6. Haims AH, Medvecky MJ, Pavlovich Jr R, Katz LD. MR imaging of the anatomy of and injuries to the lateral and posterolateral aspects of the knee. AJR Am J Roentgenol. 2003;180(3):647–53.

    Article  PubMed  Google Scholar 

  7. Pacholke DA, Helms CA. MRI of the posterolateral corner injury: a concise review. J Magn Reson Imaging: JMRI. 2007;26(2):250–5.

    PubMed  Google Scholar 

  8. Seebacher JR, Inglis AE, Marshall JL, Warren RF. The structure of the posterolateral aspect of the knee. J Bone Joint Surg Am Vol. 1982;64(4):536–41.

    CAS  Google Scholar 

  9. Beals TC. So who was Gerdy… and how did he get his own tubercle? Am J Orthop (Belle Mead NJ). 1996;25(11):750–2.

    CAS  PubMed  Google Scholar 

  10. Kaplan EB. The iliotibial tract; clinical and morphological significance. J Bone Joint Surg Am Vol. 1958;40–A(4):817–32.

    Google Scholar 

  11. Muhle C, Ahn JM, Yeh L, Bergman GA, Boutin RD, Schweitzer M, et al. Iliotibial band friction syndrome: MR imaging findings in 16 patients and MR arthrographic study of six cadaveric knees. Radiology. 1999;212(1):103–10.

    Article  CAS  PubMed  Google Scholar 

  12. Pelsser V, Cardinal E, Hobden R, Aubin B, Lafortune M. Extraarticular snapping hip: sonographic findings. AJR Am J Roentgenol. 2001;176(1):67–73.

    Article  CAS  PubMed  Google Scholar 

  13. Vinson EN, Major NM, Helms CA. The posterolateral corner of the knee. AJR Am J Roentgenol. 2008;190(2):449–58.

    Article  PubMed  Google Scholar 

  14. Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, et al. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. 2006;208(3):309–16.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Vieira EL, Vieira EA, da Silva RT, Berlfein PA, Abdalla RJ, Cohen M. An anatomic study of the iliotibial tract. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc. 2007;23(3):269–74.

    Article  Google Scholar 

  16. Recondo JA, Salvador E, Villanua JA, Barrera MC, Gervas C, Alustiza JM. Lateral stabilizing structures of the knee: functional anatomy and injuries assessed with MR imaging. Radiograph Rev Publ Radiol Soc N Am, Inc. 2000;20 Spec No: S91–S102.

  17. Davis DS, Post WR. Segond fracture: lateral capsular ligament avulsion. J Orthop Sports Phys Ther. 1997;25(2):103–6.

    Article  CAS  PubMed  Google Scholar 

  18. Terry GC, Norwood LA, Hughston JC, Caldwell KM. How iliotibial tract injuries of the knee combine with acute anterior cruciate ligament tears to influence abnormal anterior tibial displacement. Am J Sports Med. 1993;21(1):55–60.

    Article  CAS  PubMed  Google Scholar 

  19. Mackenzie R, Dixon AK, Keene GS, Hollingworth W, Lomas DJ, Villar RN. Magnetic resonance imaging of the knee: assessment of effectiveness. Clin Radiol. 1996;51(4):245–50.

    Article  CAS  PubMed  Google Scholar 

  20. Sanders TG, Miller MD. A systematic approach to magnetic resonance imaging interpretation of sports medicine injuries of the knee. Am J Sports Med. 2005;33(1):131–48.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors report no conflicts of interest related to this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philip Yoong.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mansour, R., Yoong, P., McKean, D. et al. The iliotibial band in acute knee trauma: patterns of injury on MR imaging. Skeletal Radiol 43, 1369–1375 (2014). https://doi.org/10.1007/s00256-014-1918-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-014-1918-2

Keywords

Navigation