Abstract
The iliotibial band (ITB) is considered an important anterolateral knee joint stabiliser. Its exact anatomy remains unclear with inconsistency owing to relative paucity of detailed cadaveric studies. Multiple ITB distal insertional sites have been reported, the most common and well known being a direct attachment onto Gerdy’s tubercle of the anterolateral tibia. We report a rare distal insertional site not previously documented. A 50-year-old man presented with anterior knee pain. MRI showed an accessory band deep to the ITB, partially blending in with its superficial fibres. It inserted onto the anterolateral tibial tuberosity, deep to the patellar tendon insertion and inferomedial to Gerdy’s tubercle. This was asymptomatic but the patient did have an underlying median patella ridge osteochondral defect successfully treated with stem cell grafting, completely unrelated to the mentioned variant. This case highlights the importance of detecting rare anatomical variants which can potentially be a source of lateral knee pain.
Similar content being viewed by others
References
Flato R, Passanante GJ, Skalski MR, Patel DB, White EA, Matcuk GR Jr. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol. 2017;46(5):605–22.
Gerdy PN. Troisième monographie maladies des organes du mouvement os muscles. Paris: chez Victor Masson. 1855. 11.
Segond PF. Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Prog méd. 1879: 1–85. 12.
Khanna M, Gupte C, Dodds A, Williams A, Walker M. Magnetic resonance imaging appearances of the capsulo-osseous layer of the iliotibial band and femoral attachments of the iliotibial band in the normal and pivot-shift ACL injured knee. Skeletal Radiol. 2019;48(5):729–40.
Vieira EL, Vieira EA, da Silva RT, Berlfein PA, Abdalla RJ, Cohen M. An anatomic study of the iliotibial tract. Arthroscopy. 2007;23(3):269–74.
Eng CM, Arnold AS, Biewener AA, Lieberman DE. The human iliotibial band is specialized for elastic energy storage compared with the chimp fascia lata. J Exp Biol. 2015;218(Pt 15):2382–93.
Vesalius A. The epitome of Andreas Vesalius. New York: MacMillian; 1949.
Herbst E, Albers M, Burnham JM, Fu FH, Musahl V. The anterolateral complex of the knee. Orthop J Sports Med. 2017;5(10):2325967117730805.
Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M. J Sci Med Sport. 2007;10(2):74–6.
Birnbaum K, Siebert CH, Pandorf T, Schopphoff E, Prescher A, Niethard FU. Anatomical and biomechanical investigations of the iliotibial tract. Surg Radiol Anat. 2004;26(6):433–46.
Fulkerson JP, Gossling HR. Anatomy of the knee joint lateral retinaculum. Clin Orthop Relat Res. 1980 Nov-Dec;(153):183–8.
Herzog RJ. Accessory plantaris muscle: anatomy and prevalence. HSS J. 2011;7(1):52–6.
Zimmermann SM, Njagulj V, Fritz B, Fucentese SF, Sutter R, Pfirrmann CWA. The accessory iliotibial band-meniscal ligament of the knee: association with lesions of the lateral meniscus. AJR Am J Roentgenol. 2019;213(4):912–7.
Claes S, Vereecke E, Maes M, Victor J, Verdonk P, Bellemans J. Anatomy of the anterolateral ligament of the knee. J Anat. 2013;223(4):321–8.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Consent to publish
Written informed consent for publication was obtained from the patient regarding their case history and imaging.
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Rajakulasingam, R., Green, R.A.R. & Saifuddin, A. An accessory iliotibial band insertion: a unique anatomical variant. Skeletal Radiol 50, 2553–2557 (2021). https://doi.org/10.1007/s00256-021-03827-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-021-03827-3