MRI findings of iliotibial band friction syndrome in a swimmer: A case report

Introduction Iliotibial band friction syndrome (ITBFS) is one of the common painful condition due to inflamation of distal portion of iliotibial band which presents in lateral side of the knee. Repetetive movements of flexion and extension during exercise as well as excessive friction of distal iliotibial band results in its irritation and inflamation, as it slides over lateral femoral epicondyle causing friction, irritation and lateral femoral pain [1,2]. Combination of overuse and biomechanical factors are being considered in developing ITBFS [3]. It is usually seen in people having intense physical activity such as athlets (runners, cyclists, American football players) and also military personnel [1-3]. It accounts for about 15% of all overuse injuries of the knee region [4], however according to Linenger [5] ITBFS comprises about 22% of lower extremity injuries. Overall in general ITBFS has been accepted to be the most common running injury of the lateral knee region with an incidence of 1.6-12% [6,7]. The diagnosis of ITBFS depends on clinical findings including local tenderness over the lateral knee and reproducible pain during movements of flexion and extension while pressing over the lateral femoral epicondyle [2,8]. Case Report A 33-year-old female swimmer admitted to the hospital with pain especially located at the lateral side of the left knee with minimal swelling. On physical examination, tenderness of lateral femoral epicondyle was present during pressing over the lateral epicondyle with a 30-degree flexion of the knee. Laboratory blood test was unremarkable. Due to existing pain at lateral side of the left knee, magnetic resonance imaging (MRI) was performed, revealing edematous hyperintense signal changes between lateral femoral condyle, and ITB on PD-Fatsat which represented edematous changes, minimal fluid due to inflammation and irritation of ITB. These signs suggested ITBFS (Figure 1). The patient was observed conservatively for 2 months and the complaints were relieved.