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ANSWER: What is your diagnosis based on clinical exam and imaging findings?
  1. C M Nusman1,
  2. M C de Jonge2,
  3. A Navas Canete2,
  4. M Maas2
  1. 1Acadamic Medical Centre, Amsterdam, The Netherlands
  2. 2Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Mrs C M Nusman, Acadamic Medical Centre, Amsterdam, Recht Boomssloot 4A, 1011EA Amsterdam, The Netherlands; charlotte.nusman{at}hotmail.com

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Diagnosis

Iliotibial band friction syndrome (ITBFS).

Imaging findings

Coronal T2 weighted fat suppressed image of the left knee demonstrates an area of high signal intensity at the distal part of the iliotibial tract (white arrow). The area of high signal intensity indicates an ill-defined fluid collection. The tendon is still detectable as a linear low-signal-intensity structure within the fluid collection.

Normal thickness of the tendon is seen on the axial T2 weighted fat suppressed image (small white arrow). No evident bone marrow oedema is found. A normal aspect of the lateral meniscus (small white arrows) is seen.

Treatment

The patient was advised to abstain from running for 4 weeks and prescribed a graded exercise programme. Her complaints disappeared after finishing the programme, and she has since successfully resumed running marathons.

Discussion

ITBFS is one of the most common causes of knee pain in runners; it may also occur in cyclists and is therefore also referred to as ‘runner’s knee' or ‘cyclist’s knee.' It should be noted that these synonyms can cause confusion, as some authors may use the term ‘runner’s knee' to describe patello-femoral pain.

In 2002, ITBFS was the second most common overuse …

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