The iliotibial tract: imaging, anatomy, injuries, and other pathology

Abstract

The iliotibial tract, also known as Maissiat’s band or the iliotibial band, and its associated muscles function to extend, abduct, and laterally rotate the hip, as well as aid in the stabilization of the knee. A select group of associated injuries and pathologies of the iliotibial tract are seen as sequela of repetitive stress and direct trauma. This article intends to educate the radiologist, orthopedist, and other clinicians about iliotibial tract anatomy and function and the clinical presentation, pathophysiology, and imaging findings of associated pathologies. Specifically, this article will review proximal iliotibial band syndrome, Morel-Lavallée lesions, external snapping hip syndrome, iliotibial band syndrome and bursitis, traumatic tears, iliotibial insertional tendinosis and peritendonitis, avulsion fractures at Gerdy’s tubercle, and Segond fractures. The clinical management of these pathologies will also be discussed in brief.

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

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13

References

  1. 1.

    Gray H. Anatomy of the human body. 20th edition ed. Philadelphia: Lea & Febiger; 1918.

    Google Scholar 

  2. 2.

    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.

    PubMed  Article  Google Scholar 

  3. 3.

    Hirschmann MT, Müller W. Complex function of the knee joint: the current understanding of the knee. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2780–8.

    PubMed  Article  Google Scholar 

  4. 4.

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

    PubMed  Article  Google Scholar 

  5. 5.

    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. 2012;19(4):378–85.

    PubMed  Article  Google Scholar 

  6. 6.

    Mansour R, Yoong P, McKean D, Teh JL. The iliotibial band in acute knee trauma: patterns of injury on MR imaging. Skeletal Radiol. 2014;43(10):1369–75.

    PubMed  Article  Google Scholar 

  7. 7.

    Ellis R, Hing W, Reid D. Iliotibial band friction syndrome—a systematic review. Man Ther. 2007;12(3):200–8.

    PubMed  Article  Google Scholar 

  8. 8.

    Vesalius A. The Epitome of Andrea Vesalius. New York: The Macmillan Company, 1949: 38.

  9. 9.

    Terry GC, Hughston JC, Norwood LA. The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med. 1986;14(1):39–45.

    CAS  PubMed  Article  Google Scholar 

  10. 10.

    Gerdy PN. Troisième monographie maladies des organes du mouvement os muscles. Paris: chez Victor Masson. 1855.

  11. 11.

    Segond PF. Recherches cliniques et expérimentales sur les épanchements sanguins du genou par entorse. Prog méd. 1879:1–85.

  12. 12.

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

    CAS  PubMed  Article  Google Scholar 

  13. 13.

    Sher I, Umans H, Downie SA, Tobin K, Arora R, Olson TR. Proximal iliotibial band syndrome: what is it and where is it? Skeletal Radiol. 2011;40(12):1553–6.

    PubMed  Article  Google Scholar 

  14. 14.

    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.

    CAS  PubMed  Article  Google Scholar 

  15. 15.

    Netter FH. Atlas of Human Anatomy. 6th Edition ed. Philadelphia: Saunders; 2014.

    Google Scholar 

  16. 16.

    Huang BK, Campos JC, Michael Peschka PG, et al. Injury of the gluteal aponeurotic fascia and proximal iliotibial band: anatomy, pathologic conditions, and MR imaging. Radiographics. 2013;33(5):1437–52.

    PubMed  Article  Google Scholar 

  17. 17.

    Daggett M, Claes S, Helito CP, et al. The role of the anterolateral structures and the ACL in controlling laxity of the intact and ACL-deficient knee: letter to the editor. Am J Sports Med. 2016;44(4):NP14–5.

    PubMed  Article  Google Scholar 

  18. 18.

    Fairclough J, Hayashi K, Toumi H, 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.

    PubMed  PubMed Central  Article  Google Scholar 

  19. 19.

    Evans P. The postural function of the iliotibial tract. Ann R Coll Surg Engl. 1979;61(4):271–80.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. 20.

    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.

    PubMed  PubMed Central  Article  Google Scholar 

  21. 21.

    Lieb FJ, Perry J. Quadriceps function. An anatomical and mechanical study using amputated limbs. J Bone Joint Surg Am. 1968;50(8):1535–48.

    CAS  PubMed  Article  Google Scholar 

  22. 22.

    Kennedy JC, Weinberg HW, Wilson AS. The anatomy and function of the anterior cruciate ligament. As determined by clinical and morphological studies. J Bone Joint Surg Am. 1974;56(2):223–35.

    CAS  PubMed  Article  Google Scholar 

  23. 23.

    Kennedy JC, Stewart R, Walker DM. Anterolateral rotatory instability of the knee joint. An early analysis of the Ellison procedure. J Bone Joint Surg Am. 1978;60(8):1031–9.

    CAS  PubMed  Article  Google Scholar 

  24. 24.

    Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am. 1976;58(2):173–9.

    CAS  PubMed  Article  Google Scholar 

  25. 25.

    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.

    CAS  PubMed  Article  Google Scholar 

  26. 26.

    Kosy JD, Soni A, Venkatesh R, Mandalia VI. The anterolateral ligament of the knee: unwrapping the enigma. Anatomical study and comparison to previous reports. J Orthop Traumatol. 2016.

  27. 27.

    Caterine S, Litchfield R, Johnson M, Chronik B, Getgood A. A cadaveric study of the anterolateral ligament: re-introducing the lateral capsular ligament. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):3186–95.

    PubMed  Article  Google Scholar 

  28. 28.

    Vincent JP, Magnussen RA, Gezmez F, et al. The anterolateral ligament of the human knee: an anatomic and histologic study. Knee Surg Sports Traumatol Arthrosc. 2012;20(1):147–52.

    PubMed  Article  Google Scholar 

  29. 29.

    Stijak L, Bumbaširević M, Radonjić V, et al. Anatomic description of the anterolateral ligament of the knee. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2083–8.

    PubMed  Article  Google Scholar 

  30. 30.

    Helito CP, Demange MK, Bonadio MB, et al. Anatomy and histology of the knee anterolateral ligament. Orthop J Sports Med. 2013;1(7):2325967113513546.

    PubMed  PubMed Central  Article  Google Scholar 

  31. 31.

    LaPrade RF. Editorial commentary: defining the anatomy of the anterolateral aspect of the knee among experts is clearly needed. Arthroscopy. 2016;32(5):842–3.

    PubMed  Article  Google Scholar 

  32. 32.

    LaPrade RF. Editorial commentary: it is all about how one defines the anatomy. Arthroscopy. 2016;32(5):849–50.

    PubMed  Article  Google Scholar 

  33. 33.

    Haims AH, Medvecky MJ, Pavlovich 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.

    PubMed  Article  Google Scholar 

  34. 34.

    Murphy BJ, Hechtman KS, Uribe JW, Selesnick H, Smith RL, Zlatkin MB. Iliotibial band friction syndrome: MR imaging findings. Radiology. 1992;185(2):569–71.

    CAS  PubMed  Article  Google Scholar 

  35. 35.

    Vasilevska V, Szeimies U, Stäbler A. Magnetic resonance imaging signs of iliotibial band friction in patients with isolated medial compartment osteoarthritis of the knee. Skeletal Radiol. 2009;38(9):871–5.

    PubMed  Article  Google Scholar 

  36. 36.

    Muhle C, Ahn JM, Yeh L, 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.

    CAS  PubMed  Article  Google Scholar 

  37. 37.

    Ekman EF, Pope T, Martin DF, Curl WW. Magnetic resonance imaging of iliotibial band syndrome. Am J Sports Med. 1994;22(6):851–4.

    CAS  PubMed  Article  Google Scholar 

  38. 38.

    Wang HK, Ting-Fang Shih T, Lin KH, Wang TG. Real-time morphologic changes of the iliotibial band during therapeutic stretching; an ultrasonographic study. Man Ther. 2008;13(4):334–40.

    PubMed  Article  Google Scholar 

  39. 39.

    Goh LA, Chhem RK, Wang SC, Chee T. Iliotibial band thickness: sonographic measurements in asymptomatic volunteers. J Clin Ultrasound. 2003;31(5):239–44.

    PubMed  Article  Google Scholar 

  40. 40.

    Gyaran IA, Spiezia F, Hudson Z, Maffulli N. Sonographic measurement of iliotibial band thickness: an observational study in healthy adult volunteers. Knee Surg Sports Traumatol Arthrosc. 2011;19(3):458–61.

    PubMed  Article  Google Scholar 

  41. 41.

    De Maeseneer M, Marcelis S, Boulet C, et al. Ultrasound of the knee with emphasis on the detailed anatomy of anterior, medial, and lateral structures. Skeletal Radiol. 2014;43(8):1025–39.

    PubMed  Google Scholar 

  42. 42.

    Bonaldi VM, Chhem RK, Drolet R, Garcia P, Gallix B, Sarazin L. Iliotibial band friction syndrome: sonographic findings. J Ultrasound Med. 1998;17(4):257–60.

    CAS  PubMed  Article  Google Scholar 

  43. 43.

    Lewis CL. Extra-articular snapping hip: a literature review. Sports Health. 2010;2(3):186–90.

    PubMed  PubMed Central  Article  Google Scholar 

  44. 44.

    Chang KS, Cheng YH, Wu CH, Özçakar L. Dynamic ultrasound imaging for the iliotibial band/snapping hip syndrome. Am J Phys Med Rehabil. 2015;94(6):e55–6.

    PubMed  Article  Google Scholar 

  45. 45.

    Marchand AJ, Proisy M, Ropars M, Cohen M, Duvauferrier R, Guillin R. Snapping knee: imaging findings with an emphasis on dynamic sonography. AJR Am J Roentgenol. 2012;199(1):142–50.

    PubMed  Article  Google Scholar 

  46. 46.

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

    CAS  PubMed  Article  Google Scholar 

  47. 47.

    Bonilla-Yoon I, Masih S, Patel DB, et al. The Morel-Lavallée lesion: pathophysiology, clinical presentation, imaging features, and treatment options. Emerg Radiol. 2014;21(1):35–43.

    PubMed  Article  Google Scholar 

  48. 48.

    Scolaro JA, Chao T, Zamorano DP. The Morel-Lavallée lesion: diagnosis and management. J Am Acad Orthop Surg. 2016;24(10):667-72.

  49. 49.

    Mellado JM, Bencardino JT. Morel-Lavallée lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am. 2005;13(4):775–82.

    PubMed  Article  Google Scholar 

  50. 50.

    Mellado JM, Pérez del Palomar L, Díaz L, Ramos A, Saurí A. Long-standing Morel-Lavallée lesions of the trochanteric region and proximal thigh: MRI features in five patients. AJR Am J Roentgenol. 2004;182(5):1289–94.

    CAS  PubMed  Article  Google Scholar 

  51. 51.

    Reddix RN, Carroll E, Webb LX. Early diagnosis of a Morel-Lavallee lesion using three-dimensional computed tomography reconstructions: a case report. J Trauma. 2009;67(2):E57–9.

    PubMed  Article  Google Scholar 

  52. 52.

    Neal C, Jacobson JA, Brandon C, Kalume-Brigido M, Morag Y, Girish G. Sonography of Morel-Lavallee lesions. J Ultrasound Med. 2008;27(7):1077–81.

    PubMed  Article  Google Scholar 

  53. 53.

    Choudhary AK, Methratta S. Morel-Lavallée lesion of the thigh: characteristic findings on US. Pediatr Radiol. 2010;40 Suppl 1:S49.

    PubMed  Article  Google Scholar 

  54. 54.

    Choi YS, Lee SM, Song BY, Paik SH, Yoon YK. Dynamic sonography of external snapping hip syndrome. J Ultrasound Med. 2002;21(7):753–8.

    PubMed  Article  Google Scholar 

  55. 55.

    Allen WC, Cope R. Coxa Saltans: The snapping hip revisited. J Am Acad Orthop Surg. 1995;3(5):303–8.

    CAS  PubMed  Article  Google Scholar 

  56. 56.

    Schaberg JE, Harper MC, Allen WC. The snapping hip syndrome. Am J Sports Med. 1984;12(5):361–5.

    CAS  PubMed  Article  Google Scholar 

  57. 57.

    Zbojniewicz AM. US for diagnosis of musculoskeletal conditions in the young athlete: emphasis on dynamic assessment. Radiographics. 2014;34(5):1145–62.

    PubMed  Article  Google Scholar 

  58. 58.

    Deslandes M, Guillin R, Cardinal E, Hobden R, Bureau NJ. The snapping iliopsoas tendon: new mechanisms using dynamic sonography. AJR Am J Roentgenol. 2008;190(3):576–81.

    PubMed  Article  Google Scholar 

  59. 59.

    Krishnamurthy G, Connolly BL, Narayanan U, Babyn PS. Imaging findings in external snapping hip syndrome. Pediatr Radiol. 2007;37(12):1272–4.

    PubMed  Article  Google Scholar 

  60. 60.

    Chang CY, Kreher J, Torriani M. Dynamic sonography of snapping hip due to gluteus maximus subluxation over greater trochanter. Skeletal Radiol. 2016;45(3):409–12.

    PubMed  Article  Google Scholar 

  61. 61.

    Larsen E, Johansen J. Snapping hip. Acta Orthop Scand. 1986;57(2):168–70.

    CAS  PubMed  Article  Google Scholar 

  62. 62.

    Inoue S, Noguchi Y, Mae T, Rikimaru S, Hotokezaka S. An external snapping hip caused by osteochondroma of the proximal femur. Mod Rheumatol. 2005;15(6):432–4.

    PubMed  Article  Google Scholar 

  63. 63.

    Satku K, Chia J, Kumar VP. Snapping hip—an unusual cause. J Bone Joint Surg (Br). 1990;72(1):150–1.

    CAS  Google Scholar 

  64. 64.

    Battaglia M, Guaraldi F, Monti C, Vanel D, Vannini F. An unusual cause of external snapping hip. J Radiol Case Rep. 2011;5(10):1–6.

    PubMed  PubMed Central  Google Scholar 

  65. 65.

    Larsen E, Gebuhr P. Snapping hip after total hip replacement. A report of four cases. J Bone Joint Surg Am. 1988;70(6):919–20.

    CAS  PubMed  Article  Google Scholar 

  66. 66.

    Hodnett PA, Shelly MJ, MacMahon PJ, Kavanagh EC, Eustace SJ. MR imaging of overuse injuries of the hip. Magn Reson Imaging Clin N Am. 2009;17(4):667–79. vi.

    PubMed  Article  Google Scholar 

  67. 67.

    Lavine R. Iliotibial band friction syndrome. Curr Rev Musculoskelet Med. 2010;3(1–4):18–22.

    PubMed  PubMed Central  Article  Google Scholar 

  68. 68.

    Linenger JM, West LA. Epidemiology of soft-tissue/musculoskeletal injury among US Marine recruits undergoing basic training. Mil Med. 1992;157(9):491–3.

    CAS  PubMed  Google Scholar 

  69. 69.

    Renne JW. The iliotibial band friction syndrome. J Bone Joint Surg Am. 1975;57(8):1110–1.

    CAS  PubMed  Article  Google Scholar 

  70. 70.

    Nemeth WC, Sanders BL. The lateral synovial recess of the knee: anatomy and role in chronic Iliotibial band friction syndrome. Arthroscopy. 1996;12(5):574–80.

    CAS  PubMed  Article  Google Scholar 

  71. 71.

    Costa ML, Marshall T, Donell ST, Phillips H. Knee synovial cyst presenting as iliotibial band friction syndrome. Knee. 2004;11(3):247–8.

    CAS  PubMed  Article  Google Scholar 

  72. 72.

    Hariri S, Savidge ET, Reinold MM, Zachazewski J, Gill TJ. Treatment of recalcitrant iliotibial band friction syndrome with open iliotibial band bursectomy: indications, technique, and clinical outcomes. Am J Sports Med. 2009;37(7):1417–24.

    PubMed  Article  Google Scholar 

  73. 73.

    Fairclough J, Hayashi K, Toumi H, et al. Is iliotibial band syndrome really a friction syndrome? J Sci Med Sport. 2007;10(2):74–6. discussion 7–8.

    PubMed  Article  Google Scholar 

  74. 74.

    Jelsing EJ, Finnoff JT, Cheville AL, Levy BA, Smith J. Sonographic evaluation of the iliotibial band at the lateral femoral epicondyle: does the iliotibial band move? J Ultrasound Med. 2013;32(7):1199–206.

    PubMed  Article  Google Scholar 

  75. 75.

    Cowden CH, Barber FA. Arthroscopic treatment of iliotibial band syndrome. Arthrosc Tech. 2014;3(1):e57–60.

    PubMed  Article  Google Scholar 

  76. 76.

    Lui TH. Endoscopic resection of lateral synovial cyst of the knee. Arthrosc Tech. 2015;4(6):e815–8.

    PubMed  PubMed Central  Article  Google Scholar 

  77. 77.

    Holmes JC, Pruitt AL, Whalen NJ. Iliotibial band syndrome in cyclists. Am J Sports Med. 1993;21(3):419–24.

    CAS  PubMed  Article  Google Scholar 

  78. 78.

    Michels F, Jambou S, Allard M, Bousquet V, Colombet P, de Lavigne C. An arthroscopic technique to treat the iliotibial band syndrome. Knee Surg Sports Traumatol Arthrosc. 2009;17(3):233–6.

    CAS  PubMed  Article  Google Scholar 

  79. 79.

    Martens M, Libbrecht P, Burssens A. Surgical treatment of the iliotibial band friction syndrome. Am J Sports Med. 1989;17(5):651–4.

    CAS  PubMed  Article  Google Scholar 

  80. 80.

    Isusi M, Oleaga L, Campo M, Grande D. MRI findings in iliotibial band friction syndrome: a report of two cases. Radiologia. 2007;49(6):433–5.

    CAS  PubMed  Article  Google Scholar 

  81. 81.

    Grando H, Chang EY, Chen KC, Chung CB. MR imaging of extrasynovial inflammation and impingement about the knee. Magn Reson Imaging Clin N Am. 2014;22(4):725–41.

    PubMed  Article  Google Scholar 

  82. 82.

    van der Worp MP, van der Horst N, de Wijer A, Backx FJ. Nijhuis-van der Sanden MW. Iliotibial band syndrome in runners: a systematic review. Sports Med. 2012;42(11):969–92.

    PubMed  Article  Google Scholar 

  83. 83.

    Aderem J, Louw QA. Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC Musculoskelet Disord. 2015;16:356.

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  84. 84.

    Louw M, Deary C. The biomechanical variables involved in the aetiology of iliotibial band syndrome in distance runners—A systematic review of the literature. Phys Ther Sport. 2014;15(1):64–75.

    PubMed  Article  Google Scholar 

  85. 85.

    Baker RL, Fredericson M. Iliotibial band syndrome in runners: biomechanical implications and exercise interventions. Phys Med Rehabil Clin N Am. 2016;27(1):53–77.

    PubMed  Article  Google Scholar 

  86. 86.

    Strauss EJ, Kim S, Calcei JG, Park D. Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 2011;19(12):728–36.

    PubMed  Article  Google Scholar 

  87. 87.

    Noehren B, Schmitz A, Hempel R, Westlake C, Black W. Assessment of strength, flexibility, and running mechanics in men with iliotibial band syndrome. J Orthop Sports Phys Ther. 2014;44(3):217–22.

    PubMed  PubMed Central  Article  Google Scholar 

  88. 88.

    Sangkaew C. Surgical treatment of iliotibial band friction syndrome with the mesh technique. Arch Orthop Trauma Surg. 2007;127(4):303–6.

    PubMed  Article  Google Scholar 

  89. 89.

    Nishimura G, Yamato M, Tamai K, Takahashi J, Uetani M. MR findings in iliotibial band syndrome. Skeletal Radiol. 1997;26(9):533–7.

    CAS  PubMed  Article  Google Scholar 

  90. 90.

    O’Keeffe SA, Hogan BA, Eustace SJ, Kavanagh EC. Overuse injuries of the knee. Magn Reson Imaging Clin N Am. 2009;17(4):725–39. vii.

    PubMed  Article  Google Scholar 

  91. 91.

    Draghi F, Danesino GM, Coscia D, Precerutti M, Pagani C. Overload syndromes of the knee in adolescents: sonographic findings. J Ultrasound. 2008;11(4):151–7.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  92. 92.

    Marra MD, Crema MD, Chung M, et al. MRI features of cystic lesions around the knee. Knee. 2008;15(6):423–38.

    PubMed  Article  Google Scholar 

  93. 93.

    Beaman FD, Peterson JJ. MR imaging of cysts, ganglia, and bursae about the knee. Radiol Clin North Am. 2007;45(6):969–82. vi.

    PubMed  Article  Google Scholar 

  94. 94.

    Gunter P, Schwellnus MP. Local corticosteroid injection in iliotibial band friction syndrome in runners: a randomised controlled trial. Br J Sports Med. 2004;38(3):269–72. discussion 72.

    CAS  PubMed  PubMed Central  Article  Google Scholar 

  95. 95.

    Hong JH, Kim JS. Diagnosis of iliotibial band friction syndrome and ultrasound guided steroid injection. Korean J Pain. 2013;26(4):387–91.

    PubMed  PubMed Central  Article  Google Scholar 

  96. 96.

    LaPrade RF, Gilbert TJ, Bollom TS, Wentorf F, Chaljub G. The magnetic resonance imaging appearance of individual structures of the posterolateral knee. A prospective study of normal knees and knees with surgically verified grade III injuries. Am J Sports Med. 2000;28(2):191–9.

    CAS  PubMed  Google Scholar 

  97. 97.

    Gottsegen CJ, Eyer BA, White EA, Learch TJ, Forrester D. Avulsion fractures of the knee: imaging findings and clinical significance. Radiographics. 2008;28(6):1755–70.

    PubMed  Article  Google Scholar 

  98. 98.

    Fay K, Mannem R, Baynes K, Sarin D, DuBois M. Iliotibial band avulsion fracture: a case report with differential diagnosis. Emerg Radiol. 2016;23(1):93–6.

    PubMed  Article  Google Scholar 

  99. 99.

    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.

    CAS  PubMed  Article  Google Scholar 

  100. 100.

    Association AM. Standard Nomenclature of Athletic Injuries. Chicago: American Medical Association; 1968.

    Google Scholar 

  101. 101.

    Arend CF. Sonography of the iliotibial band: spectrum of findings. Radiol Bras. 2014;47:33–7.

    Article  Google Scholar 

  102. 102.

    Housner JA, Jacobson JA, Misko R. Sonographically guided percutaneous needle tenotomy for the treatment of chronic tendinosis. J Ultrasound Med. 2009;28(9):1187–92.

    PubMed  Article  Google Scholar 

  103. 103.

    Yoo JH, Hahn SH, Yang BK, et al. An en bloc avulsion fracture of tibial tuberosity and Gerdy’s tubercle in an adolescent basketball player: a case report. Knee Surg Sports Traumatol Arthrosc. 2007;15(6):781–5.

    PubMed  Article  Google Scholar 

  104. 104.

    Campos JC, Chung CB, Lektrakul N, et al. Pathogenesis of the Segond fracture: anatomic and MR imaging evidence of an iliotibial tract or anterior oblique band avulsion. Radiology. 2001;219(2):381–6.

    CAS  PubMed  Article  Google Scholar 

  105. 105.

    Claes S, Luyckx T, Vereecke E, Bellemans J. The Segond fracture: a bony injury of the anterolateral ligament of the knee. Arthroscopy. 2014;30(11):1475–82.

    PubMed  Article  Google Scholar 

  106. 106.

    De Maeseneer M, Boulet C, Willekens I, et al. Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma. Skeletal Radiol. 2015;44(3):413–21.

    PubMed  Article  Google Scholar 

  107. 107.

    Helito CP, Helito PV, Bonadio MB, et al. Correlation of magnetic resonance imaging with knee anterolateral ligament anatomy: a cadaveric study. Orthop J Sports Med. 2015;3(12):2325967115621024.

    PubMed  PubMed Central  Article  Google Scholar 

  108. 108.

    Helito CP, Helito PV, Costa HP, Demange MK, Bordalo-Rodrigues M. Assessment of the anterolateral ligament of the knee by magnetic resonance imaging in acute injuries of the anterior cruciate ligament. Arthroscopy. 2017;33(1):140–6.

    PubMed  Article  Google Scholar 

  109. 109.

    Kosy JD, Mandalia VI, Anaspure R. Characterization of the anatomy of the anterolateral ligament of the knee using magnetic resonance imaging. Skeletal Radiol. 2015;44(11):1647–53.

    PubMed  Article  Google Scholar 

  110. 110.

    Porrino Jr J, Maloney E, Richardson M, Mulcahy H, Ha A, Chew FS. The anterolateral ligament of the knee: MRI appearance, association with the Segond fracture, and historical perspective. AJR Am J Roentgenol. 2015;204(2):367–73.

    PubMed  Article  Google Scholar 

  111. 111.

    Van Dyck P, Clockaerts S, Vanhoenacker FM, et al. Anterolateral ligament abnormalities in patients with acute anterior cruciate ligament rupture are associated with lateral meniscal and osseous injuries. Eur Radiol. 2016;26(10):3383–91.

    PubMed  Article  Google Scholar 

  112. 112.

    Weber WN, Neumann CH, Barakos JA, Petersen SA, Steinbach LS, Genant HK. Lateral tibial rim (Segond) fractures: MR imaging characteristics. Radiology. 1991;180(3):731–4.

    CAS  PubMed  Article  Google Scholar 

  113. 113.

    Boutry N, Dupont S, Glaude E, Demondion X, Laffargue P, Cotten A. Segond fracture revealed by ultrasonography. J Ultrasound Med. 2005;24(10):1431–5.

    PubMed  Article  Google Scholar 

  114. 114.

    Helito CP, Helito PV, Costa HP, et al. MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans. Skeletal Radiol. 2014;43(10):1421–7.

    PubMed  Article  Google Scholar 

  115. 115.

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

    CAS  PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to George R. Matcuk Jr..

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest.

Grants received

None

Disclosures

None

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Flato, R., Passanante, G.J., Skalski, M.R. et al. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol 46, 605–622 (2017). https://doi.org/10.1007/s00256-017-2604-y

Download citation

Keywords

  • Iliotibial tract
  • Maissiat’s band
  • Fascia lata
  • Gerdy’s tubercle
  • Iliotibial band syndrome
  • External snapping hip