Pathology
ITB rubbing on LFC
- long distance runners (slow running more at risk than fast)
- cyclists (seat too high, improper technique)
ITB becomes tight, especially posterior portion
Develop inflammed tissue under ITB
- synovium
- bursa
Aetiology
Overuse
- sudden increase in distance
- hill running
- genu varum
- improper shoe wear
Examination
Point tenderness
Ober Test
- unaffected knee and hip at 90o
- abduct hip, flex knee
- if ITB tight, unable to drop below horizontal
Investigations
Xray / MRI
- exclude other diagnosis
- stress fractures
- ganglion
MRI
Nishimura et al Skeletal Radiol 1997
- swelling and oedema behind ITB
- usually the posterior portion
- no evidence of thickening of ITB
Non operative
Physiotherapy
NSAID / HCLA injections
- settle the acute phase
- allow aggressive ITB stretching
Operative
Options
1. Local excision of ellipse / portion of ITB that is catching
2. ITB lengthening
3. Excision ITB bursa
Results
Hariri et al Am J Sports Med 2009
- 11 ITB bursectomies followed up for 20 months
- 9/11 completely or mostly satisfied