eMedicine Specialties > Sports Medicine > Lower Limb

Iliotibial Band Syndrome: Differential Diagnoses & Workup

Author: Jerold M Stirling, MD, Chairman of Pediatrics, Professor of Pediatrics and Orthopedics, Loyola University Medical Center
Coauthor(s): Pietro M Tonino, MD, Director and Associate Professor of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation, Loyola University Chicago, Stritch School of Medicine; Consulting Staff, Loyola University Medical Center; Timothy D Marsho, DO, Staff Physician, Department of Pediatrics, Loyola University Medical Center
Contributor Information and Disclosures

Updated: Jan 4, 2008

Differential Diagnoses

Lateral Collateral Knee Ligament Injury

Other Problems to Be Considered

Anterior cruciate ligament tear, with or without posterolateral corner injury
Common peroneal nerve injury
Degenerative joint disease
Femoral stress fracture
Gastrocnemius strain or tear
Herniated disk, with radiating lateral thigh pain
Infection
Lateral femoral condyle bone bruise
Lateral femoral condyle cartilage injury
Lateral meniscus tear
Neoplasm
Popliteus tendon injury
Posterolateral corner injury
Proximal tibiofibular joint injury
Tendinitis (biceps femoris, vastus lateralis, and popliteus) 

See also the following on eMedicine:
Anterior Cruciate Ligament Injury [in the Physical Medicine and Rehabilitation section]
Disk Herniation
Femoral Neck Stress and Insufficiency Fractures [in the Orthopedic Surgery section]
Femoral Neck Stress Fracture [in the Sports Medicine section]
Herniated Nucleus Pulposus
Knee, Anterior Cruciate Ligament Injuries (MRI) [in the Radiology section]
Knee, Posterior Cruciate Ligament Injuries (MRI) [in the Radiology section]
Lumbar Disc Disease
Lumbar Disk Problems in the Athlete
Medial Collateral and Lateral Collateral Ligament Injury
Medial Gastrocnemius Strain [in the Sports Medicine section]
Patellofemoral Joint Syndromes [in the Sports Medicine section]
Patellofemoral Syndrome [in the Physical Medicine and Rehabilitation section]
Posterior Cruciate Ligament Pathology [in the Orthopedic Surgery section]
Posterior Cruciate Ligament Injury [in the Sports Medicine section]
Tendonitis

Workup

Laboratory Studies

  • No specific laboratory tests are required in the workup of ITBS.

Imaging Studies

  • Initially, radiographic studies are not indicated if the working diagnosis is completely consistent with ITBS. Radiographs are almost always negative. If the patient's history and physical are not consistent with the diagnosis of ITBS or the patient's response to treatment is unsatisfactory, radiographs are required. In some patients, the practitioner may elect to obtain radiographs on the first visit or before the athlete resumes competition.

More on Iliotibial Band Syndrome

Overview: Iliotibial Band Syndrome
Differential Diagnoses & Workup: Iliotibial Band Syndrome
Treatment & Medication: Iliotibial Band Syndrome
Follow-up: Iliotibial Band Syndrome
Multimedia: Iliotibial Band Syndrome
References
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References

  1. Ellis R, Hing W, Reid D. Iliotibial band friction syndrome--a systematic review. Man Ther. Aug 2007;12(3):200-8. [Medline].

  2. 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. Mar 2006;208(3):309-16. [Medline].

  3. Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-9. [Medline].

  4. Beynnon BD Johnson RJ, Coughlin KM. Knee. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 2nd ed. Philadelphia, Pa: Saunders; 2003:1871-2.

  5. Akuthota V, Stilp SK, Lento P. Iliotibial band syndrome. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. Philadelphia, Pa: Hanley & Belfus; 2002:328-33.

  6. Harris M, Williams CW, Stanish W, Micheli LJ, eds. Oxford Textbook of Sports Medicine. Oxford, England: Oxford University Press; 1994.

  7. Orchard JW, Fricker PA, Abud AT, Mason BR. Biomechanics of iliotibial band friction syndrome in runners. Am J Sports Med. May-Jun 1996;24(3):375-9. [Medline].

  8. Messier SP, Edwards DG, Martin DF, et al. Etiology of iliotibial band friction syndrome in distance runners. Med Sci Sports Exerc. Jul 1995;27(7):951-60. [Medline].

  9. Holmes JC, Pruitt AL, Whalen NJ. Iliotibial band syndrome in cyclists. Am J Sports Med. May-Jun 1993;21(3):419-24. [Medline].

  10. Lindenberg G, Pinshaw R, Noakes TD. Iliotibial band friction syndrome in runners. Phys Sports Med. 1984;12(5):118-130.

  11. Richards DP, Alan Barber F, Troop RL. Iliotibial band Z-lengthening. Arthroscopy. Mar 2003;19(3):326-9. [Medline].

  12. Martens M, Libbrecht P, Burssens A. Surgical treatment of the iliotibial band friction syndrome. Am J Sports Med. Sep-Oct 1989;17(5):651-4. [Medline].

  13. Gunter P, Schwellnus MP. Local corticosteroid injection in iliotibial band friction syndrome in runners: a randomised controlled trial. Br J Sports Med. Jun 2004;38(3):269-72; discussion 272. [Medline].

  14. Cardone DA, Tallia AF. Diagnostic and therapeutic injection of the hip and knee. Am Fam Physician. May 15 2003;67(10):2147-52. [Medline]. [Full Text].

  15. Henderson JM. Therapeutic drugs. What to avoid with athletes. Clin Sports Med. Apr 1998;17(2):229-43. [Medline].

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Further Reading

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Keywords

iliotibial band tendonitis/tendinitis, iliotibial band friction syndrome, ITB syndrome, ITBS

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Contributor Information and Disclosures

Author

Jerold M Stirling, MD, Chairman of Pediatrics, Professor of Pediatrics and Orthopedics, Loyola University Medical Center
Jerold M Stirling, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Coauthor(s)

Pietro M Tonino, MD, Director and Associate Professor of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation, Loyola University Chicago, Stritch School of Medicine; Consulting Staff, Loyola University Medical Center
Pietro M Tonino, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Occupational and Environmental Medicine, American College of Sports Medicine, American Medical Association, American Orthopaedic Society for Sports Medicine, Chicago Medical Society, Illinois State Medical Society, and Mid-America Orthopaedic Association
Disclosure: Nothing to disclose.

Timothy D Marsho, DO, Staff Physician, Department of Pediatrics, Loyola University Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Leslie Milne, MD, Assistant Clinical Instructor, Department of Emergency Medicine, Harvard University School of Medicine
Leslie Milne, MD is a member of the following medical societies: American College of Sports Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD, Associate Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Sports Medicine Fellowship Director, Medical College of Wisconsin
Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa, and Wilderness Medical Society
Disclosure: Nothing to disclose.

 
 
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