Age / Sex : 64 / M

Chief complaint: Chief complaint : Right knee pain (lateral portion)

1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

(Quiz는 quiz일 뿐이오니 답안은 한개만 보내주시기 바라오며, 복수의 답안을 보내주시는 분은 정답이 포함되어 있더라도 부득이 semi-correct answer로 처리토록 하겠습니다.)

Courtesy: 최상희 (Sang Hee Choi), 서울삼성병원 (Samsung medical center)

Iliotibial band friction syndrome

Discussion

Findings: Cystic area representing adventitious bursae is noted between ITB and lateral femoral condyle. Thickening of ITB is also noted.

Differential Diagnosis:

Diagnosis: Iliotibial band friction syndrome

Discussion:

Overuse injury caused by repetitive friction between the iliotibial band and the lateral femoral epicondyle during active flexion and extension of the knee

ITBFS has been described in long-distance runners, cyclists, military personnel, football players, and weight lifters

Symptoms: Lateral knee pain, tenderness over the lateral femoral epicondyle, restriction in hip adduction

Imaging findings

ü  Ill-defined signal abnormality interposed between the ITB and lateral femoral condyle (low SI on T1 and high SI on T2WI)

ü  In chronic ITBFS, thickening of the ITB and increased T2 SI superficial to ITB are occasionally seen.

ü  Cystic areas representing primary or secondary (adventitious) bursae may be identified.

References: Radiology 1999;212(1):103-110, Skeletal Radiol. 2009;38(9);817-875