Measurement of iliotibial band diameter in iliotibial band friction syndrome and comparison with an asymptomatic population

Abstract

Background Iliotibial band friction syndrome (ITBFS) is an overuse injury of the lateral aspect of the knee. This syndrome classically affects the active young population. Purpose To determine the diameter of the ITB using magnetic resonance imaging (MRI) in patients clinically diagnosed with ITBFS, compare the results with asymptomatic patients, and assess the inter-observer agreement between a senior and a junior radiologist with different levels of experience in musculoskeletal imaging. Material and Methods From April 2014 to October 2019, 78 knee MRI scans of 78 patients were included in the study group who were referred from the orthopedic clinic with a clinical diagnosis of ITBFS. In the control group, there were 114 knee MRI scans of 114 patients who had knee MRI for various reasons and had no radiological abnormality on the performed knee MRI. The ITB diameters, cut-off values, and interclass correlation coefficient (ICC) were calculated. Results Mean thickness of the ITB was higher in the study group compared to the control group in measurements done by both the senior and junior radiologists and this was statistically significant ( P < 0.001). Cut-off values of the diameters of the ITB were calculated as 2.385 for the senior radiologist and 2.420 for the junior radiologist. ICC of 0.80 was determined, which showed excellent agreement among interpreters. Conclusion ITB thickness in the study group was significantly higher than in the control group. There was also excellent agreement among the two observers. Measurement of ITB thickness on axial plane knee MRI is one of the reliable criteria for ITBFS.

Feasibility and reliability of various morphologic features on magnetic resonance imaging for iliotibial band friction syndrome

“…In this study, lateral epicondyle prominence, thick ITB-d, and larger ITB-a were found to be significantly associated factors with ITBFS. This is in line with the results of the previous studies reporting that patients with ITBFS had higher ITB thickness, ITB-a, and lateral epicondyle height than those without ITBFS [ 6 , 8 , 9 ]. There was still controversy as to whether the thick ITB caused symptoms or the misuse injury caused the ITB-d to increase [ 8 , 17 ].…”

“…Therefore, accurate diagnosis of ITBFS is important. Previous studies reported that a higher position of patella (patella alta), lateral epicondyle prominence (increment in lateral epicondyle height), thick ITB, and larger ITB-a were the morphological features associated with ITBFS [ 6 – 9 ]. However, these are subjectively measured values and there are not many studies on their reliability.…”

“…3 ), 4) ITB diameter (ITB-d) was measured in the thickest region at the level of lateral femoral epicondyle on an axial T2-weighted FS image. On the same axial image plane, the ITB area (ITB-a) was also measured by drawing free-hand region of interests (ROIs) at the thickest ITB [ 8 , 9 ] ( Fig. 4 ).…”

“…There were many previous studies to evaluate the morphological imaging features on MRI which may be helpful for diagnosis of ITBFS. Previous studies reported that patella alta, type I and III patella according to Wiberg classification, greater lateral epicondyle prominence, increment in the diameter of ITB, and larger cross-sectional area of the ITB were associated with ITBFS and could be imaging features for diagnosing ITBFS [ 5 – 9 ]. However, there was not much published information demonstrating the feasibility, inter-reader reliability, and intra-reader reliability on these various MR imaging features for diagnosis of ITBFS.…”

Friction Syndromes of the Knee

“…11 In addition to this, risk factors such as weakness in hip abductors, gait abnormalities, and increased ITB thickness have been established in further studies. 14 15 16…”