Abstract
Pathology of the fascia lata attachment at the iliac crest (FLAIC) is an under-recognized and often misdiagnosed cause of lateral hip pain. The fascia lata has a broad attachment at the lateral iliac crest with contributions from the tensor fascia lata muscle, the iliotibial band, and the gluteal aponeurosis. The FLAIC is susceptible to overuse injuries, acute traumatic injuries, and degeneration. There is a paucity of literature regarding imaging and image-guided treatment of the FLAIC. We review anatomy and pathology of the FLAIC, presenting novel high-resolution (18–24 MHz) ultrasound images including ultrasound guidance for targeted therapeutic treatment.
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Huang BK, Campos JC, Ghobrial P, et al. Injury of the gluteal aponeurotic fascia and proximal iliotibial band: anatomy, pathologic conditions, and MR imaging. Radiographics. 2013;33:1437–52.
Bass CJ, Connell DA. Sonographic findings of tensor fascia lata tendinopathy: another cause of anterior groin pain. Skelet Radiol. 2002;31:143–8.
Lungu E, Michaud J, Bureau NJ. US assessment of sports-related hip injuries. Radiographics. 2018;38:867–89.
Sher I, Umans H, Downie SA, et al. Proximal iliotibial band syndrome: what is it and where is it? Skelet Radiol. 2011;40:1553–6.
Decker G, Hunt D. Proximal iliotibial band enthesopathy in a runner: a case report. PM R. 2018. https://doi.org/10.1016/j.pmrj.2018.06.017.
Patel Am Helm ER. Poster 127. Proximal iliotibial band rupture secondary to chronic steroid use: a case report. Abstracts. PM R. 2016:S151–332.
Flato R, Passanante GJ, Skalski MR, et al. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skelet Radiol. 2017;46:605–22.
Benjamin M. The fascia of the limbs and back—a review. J Anat. 2009;214(1):1–18.
Trammell AR, Pilson H. Anatomy, lower limb, thigh, muscles, tensor fasciae latae. NCBI Bookshelf. StatPearls. 2018.
Pan J, Bredella MA. Imaging lesions of the lateral hip. Semin Musculoskelet Radiol. 2013;17(3):291–305.
Chiavaras MM, Jacobson JA. Ultrasound-guided tendon fenestration. Semin Musculoskelet Radiol. 2013;17(1):85–90.
Daniels EW, Cole D, Jacobs B, et al. Existing evidence on ultrasound-guided injections in sports medicine. Orthop J Sports Med. 2018;6(2):2325967118756576.
Adler RS, Sofka CM. Percutaneous ultrasound-guided injections in the musculoskeletal system. Ultrasound Q. 2003;19(1):3–12.
Sofka CM, Adler RS. Ultrasound-guided interventions in the foot and ankle. Semin Musculoskelet Radiol. 2002;6(2):163–8.
Drakonaki EE, Allen GM, Watura R. Ultrasound-guided intervention in the ankle and foot. Br J Radiol. 2016;89(1057):20150577.
McNally EG, Shetty S. Plantar fascia: imaging diagnosis and guided treatment. Semin Musculoskelet Radiol. 2010;14(3):334–43.
Bradberry DM, Sussman WI, Mautner K. Ultrasound-guided percutaneous needle tenotomy for chronic tensor fascia lata tendinopathy: a case series and description of sonographic findings. PM R. 2018;10:979–83.
Acknowledgements
The authors would like to acknowledge Julia Michalek, musculoskeletal sonographer, for her invaluable contributions to this paper.
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Deshmukh, S., Abboud, S.F., Grant, T. et al. High-resolution ultrasound of the fascia lata iliac crest attachment: anatomy, pathology, and image-guided treatment. Skeletal Radiol 48, 1315–1321 (2019). https://doi.org/10.1007/s00256-018-3141-z
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DOI: https://doi.org/10.1007/s00256-018-3141-z