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The iliotibial band or tract (ITB) is a condensation of fibrous tissue which extends from the tensor fascia lat a at the hip along the entire length of the lateral aspect of the thigh to insert on Gerdy’s tubercle on the anterolateral aspect of the tibia. It passes close to the lateral femoral condyle separated from it by a little connective tissue and fat and two layers of synovium lining of the knee joint. In this position, it can impinge against the lateral femoral condyle resulting in iliotibial tract friction syndrome which is also referred to as “runner’s knee”. Although classically associated with runners, step aerobics and cycling are other reported sporting associations. Clinically this presents as an area of tenderness overlying the tract two to three centimetres above the knee joint. Radiologically it is best appreciated on coronal fat suppressed images. Signs include changes within the ligament itself which becomes thickened, and changes within the surrounding soft tissues. The immediate medial and lateral relationship of the iliotibial tract is fat. Consequently increased signal within the fat surrounding the iliotibial band at the level of the lateral femoral condyle should be regarded as a sign of this condition Care should be taken in ensuring that high signal changes are differentiated from normal joint fluid or knee effusion. Treatment is by corticosteroid injection which has been reported to be effective and modification of training or adjustment to cycling equipment. Rupture of the iliotibial band can occur but is uncommon. These are most commonly seen at the level of the knee joint rather than where friction syndrome occurs.
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MCL
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ITB
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