IT Band Syndrome on MRI: Imaging Findings

Common Symptoms

• Sharp or burning lateral knee pain during running, typically onset at a consistent distance
• Tenderness over the lateral femoral epicondyle at the iliotibial band insertion
• Pain that resolves quickly with rest but returns predictably with activity
• Occasional snapping or popping sensation over the outer knee
• Lateral knee tightness that worsens with hill running or prolonged cycling

What We Look For on Imaging

• Fluid signal deep to the IT band at the lateral femoral epicondyle on coronal MRI
• Thickening of the distal iliotibial band
• Edema within the surrounding soft tissues and lateral recess
• Bone marrow edema at the lateral femoral epicondyle in severe cases
• Absence of lateral meniscal tear to confirm differential diagnosis
• Associated bursitis deep to the IT band insertion

Sources

1. Ekman EF, Pope T, Martin DF, Curl WW. Magnetic resonance imaging of iliotibial band syndrome. Am J Sports Med. 1994;22(6):851-854.
2. 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):103-110.
3. 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):309-316.
4. Strauss EJ, Kim S, Calcei JG, Park D. Iliotibial band syndrome: evaluation and management. J Am Acad Orthop Surg. 2011;19(12):728-736.