Physical Medicine and Rehabilitation for Iliotibial Band Syndrome Workup

Updated: Apr 04, 2022
  • Author: John M Martinez, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Laboratory Studies

Laboratory studies are not indicated for the diagnosis of iliotibial band syndrome. However, laboratory tests may help rule out other sources of knee pain, such as rheumatoid arthritis or a septic joint.


Imaging Studies

Imaging tests are not necessary to confirm the diagnosis of iliotibial band syndrome (ITBS). Depending on the findings of the physical examination, the physician may want to obtain radiographs of the knee to rule out other pathology such as a fracture or bone spur. In severe cases, magnetic resonance imaging (MRI) may be helpful in identifying the extent of inflammation of the ITB. Findings on MRI most commonly include thickening of the ITB in the region overlying the lateral femoral condyle and fluid collection underneath the ITB at this area. See the image below.

In this 27-year-old female marathon runner with an In this 27-year-old female marathon runner with anterolateral pain superior to the joint line, a coronal fast spin-echo T2-weighted magnetic resonance imaging scan with fat suppression demonstrates edema between the iliotibial band and the lateral femoral condyle (arrow). The edema's location is consistent with a clinical diagnosis of iliotibial band syndrome.


Local injection with corticosteroids may be indicated in patients with iliotibial band syndrome (ITBS) who do not respond to physical therapy and exercise modification. [2] If the patient still does not improve, then tendon-lengthening surgery with excision of the damaged ITB may be considered.

Surgery for the correction of ITBS has typically been an open procedure using a Z-plasty technique, although small prospective studies have used arthroscopy to create a diamond-shaped defect in the ITB. [7, 8, 26]


Histologic Findings

Histologic changes associated with acute and chronic inflammation of the iliotibial band are observed.