David McKean BMBCh, FRCR, Presenter: Nothing to Disclose

Philip Yoong FRCR, Abstract Co-Author: Nothing to Disclose

James Teh MD, Abstract Co-Author: Nothing to Disclose

Ramy Mohamed Mansour MBBCh, Abstract Co-Author: Nothing to Disclose

The appearance of the iliotibial band (ITB) is rarely described in MRI of acute knee trauma. The purpose of our study is to investigate the characteristic patterns of injury seen with injury of the ITB. We hypothesize that injury of the ITB on MRI is associated with internal derangement, in particular anterior cruciate ligament (ACL) tears and posterolateral corner disruption.

A retrospective review was completed of 200 MRI scans performed for acute knee trauma. Patients were excluded if there was a history of injury over 4 weeks from the time of the scan, septic arthritis, inflammatory arthropathy, previous knee surgery or significant artefact. In each scan, the ITB was scored as normal, minor sprain (Grade 1), severe sprain (Grade 2) and torn (Grade 3). The menisci, ligaments and tendons of each knee were also assessed.

The mean age was 27.4 years (range 9-69). 71.5% (n = 143) patients were male. The ITB was injured in 115 cases (57.5%). The next most common soft tissue structure injured was the ACL in 53.5% (n=107). Grade 1 ITB injury was seen in 90 of these cases (45%), Grade 2 injury in 20 cases and Grade 3 injury in only 5 cases. There is a significant association between ITB injury and ACL rupture (P <0.05), as well as acute patellar dislocation (P<0.05). There were ten cases of significant posterolateral corner injury, and all were associated with ITB injury, including four ITB tears. Only two cases of isolated ITB injury were seen (1%).

ITB injury is strongly associated with significant internal derangement of the knee, especially cruciate ligament rupture, posterolateral corner injury and patellar dislocation.

Injury of the iliotibial band on MRI is associated with internal derangement, in particular anterior cruciate ligament (ACL) tears and posterolateral corner disruption.

McKean, D, Yoong, P, Teh, J, Mansour, R, The Iliotibial Band in Acute Knee Trauma: Patterns of Injury on MR Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045619.html