Musculoskeletal Imaging

Iliotibial tract

1. Anatomy

part of the lateral supporting structures of the knee, consisting of the condensed portion of the most superficial layer (composed of the deep fascia of the thigh and calf). It extends from the iliac crest above to insert on Gerdys tubercle on the anterolateral surface of the proximal end of the tibia.

2. Pathology

Injuries to the iliotibial tract usually occur comcomitantly with injuries to other lateral supporting structures of the knee. Avulsion injuries may occur at Gerdy's tubercle.

MR imaging is of value in detecting abnormalities involving this structure related to trauma, such as iliotibial tract friction syndrome (Fig.1). On coronal MR images the normal iliotibial tract appears as a structure of low signal intensity traversing the lateral portion of the thigh, extending across the lateral aspect of the knee. The tract shows discontinuity and oedema is observed in the tibia adjacent to the site of its attachment after injury.

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Fig.1

Coronal fat-suppressed proton-density-weighted MR image of the knee demonstrates the low signal intensity iliotibial tract (arrowheads). This patient has oedema of the soft tissues deep to the iliotibial tract (arrow) owing to iliotibial friction band syndrome. A small amount of oedema also is present in the adjacent femur (arrow).
Iliotibial tract, Fig.1