Diagnosis of iliotibial band friction syndrome and ultrasound guided steroid injection

Abstract

A 64-year-old woman visited our pain clinic with the pain of right lateral side of thigh for one year. Her pain always started from knee and was radiated to buttock area when symptom was severe. She showed significant tenderness at knee lateral side and local tightness at lateral thigh. Magnetic resonance image of the knee was performed and we could identify high signal intensity of iliotibial band through coronal and axial view. In spite of medication and physical stretching exercise of iliotibial band for one month, she did not show any improvement of pain. To alleviate her symptom, ultrasound guided local corticosteroid injection targeting beneath the iliotibial band was performed. After the procedure, the reduction of pain was significant and there was no need for further management.

Keywords: iliotibial band syndrome; knee; ultrasound.

Fig. 1

Axial (A) and coronal (B) T2 weighted magnetic resonance images of 64-year-old patient showing increased signal intensity medial to the iliotibial band (arrow) around the lateral femoral epicondyle.

Fig. 2

Ultrasound image of iliotibial band (ITB), recess (RC), lateral femoral epicondyle (F LC), and tibia (TB). Local fluid collection is shown beneath the iliotibial band (A). The needle path approaching the local inflammatory site beneath the iliotibial band (B).