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Iliotibial Band Friction Syndrome 726.60 M70.50

 

synonyms: Iliotibial band syndrome, IT band friction syndrome, IT band, iliotibial band syndrome, runners knee, iliotibial band friction syndrome

IT Band Friction Syndrome ICD-10

  • M70.50:    Other bursitis of knee, unspecified knee

IT Band Friction Syndrome ICD-9

  • 726.60 Enthesopathy of the knee, unspecified bursitis of the knee NOS

IT Band Friction Syndrome Etiology / Epidemiology / Natural History

  • common  cause of lateral knee pain in runners and cyclists.  Especially those who run up hills. 
  • caused by increased friction between IT band and lateral femoral condyle by increased tension in lateral structures.
  • related to  malignment: genu varum, tibial vara, heel varus, forefoot supination
  • Most common cause of lateral knee pain in long-distance runners. Increase with running downhill.

IT Band Friction Syndrome Anatomy

  • Associated with anatomic factors producing increases lateral knee forces: genu varus, tibia vara, heel varus, forefoot suppination and compensatory foot pronation

IT Band Friction Syndrome Clinical Evaluation

  • Lateral knee pain +/- radiation. Point of maximal discomfort is generally 3cm proximal to the lateral joint line over the lateral epicondyle. Pain is maximal at 30 degrees of flexion.
  • Symptoms initially started after running several miles. Pain-free period shortens with continued activity.
  • Evaluate anatomic factors: genu varus, tibia vara, heel varus, forefoot suppination and compensatory foot pronation.
  • Ober's test: evaluates IT band tightness. With the patient in the lateral position, affected side down, the unaffected hip and knee are flexed. The involved knee is flexed 90 degrees and the ipsilateral hip is abducted and hyperextended. IT band tightness prevents the leg from dropping below the horizontal.

IT Band Friction Syndrome Diagnositc Tests

  • A/P and lateral views of knee. Generally normal.

IT Band Friction Syndrome Classification / Treatment

  • Change running activities such as running down hill, and running in the same direction on the track. Change stride length. Cyclics can change seat height.
  • Evaluate anatomic factors: genu varus, tibia vara, heel varus, forefoot suppination and compensatory foot pronation.
  • Ice, NSAIDs
  • IT band and hip external rotator stretching and strengthening hip abductors. 
  • Consider rigid orthotic for excessive pronation; lateral heel wedge for tight IT band.
  • Consider Iliotibial Band Compression Wrap 
  • +/- cortisone injections or iontophoresis.
  • Surgery = only after failure of prolonged non-operative treatment. Resection of the triangular piece of the iliotibial band that contacts the lateral femoral epicondyle when the knee is flexed to 30 degrees. (Martens M, Am J Sports Med 1989;17:651)

IT Band Friction Syndrome Associated Injuries / Differential Diagnosis

IT Band Friction Syndrome Complications

IT Band Friction Syndrome Follow-up Care

IT Band Friction Syndrome Review References

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