DOI QR코드

DOI QR Code

Feasibility and reliability of various morphologic features on magnetic resonance imaging for iliotibial band friction syndrome

  • Jin Kyem Kim (Department of Radiology, The Armed Forces Capital Hospital) ;
  • Taeho Kim (Department of Radiology, The Armed Forces Capital Hospital) ;
  • Hong Seon Lee (Department of Radiology, The Armed Forces Capital Hospital) ;
  • Dong Kyu Kim (Department of Radiology, The Armed Forces Capital Hospital)
  • Received : 2022.12.02
  • Accepted : 2023.01.16
  • Published : 2023.04.01

Abstract

Background: To evaluate the feasibility, inter-reader reliability, and intra-reader reliability for various morphological features reported to be related to iliotibial band friction syndrome (ITBFS) on knee magnetic resonance imaging (MRI). Methods: A total of 145 patients with a clinical diagnosis and knee MRI findings consistent with ITBFS were included in the "study group" and 232 patients without knee pathology on both physical examination and MRI were included in the "control group". Various morphologic features on knee MRI were assessed including the patella shape, patella height, lateral epicondyle anterior-posterior (AP) width, lateral epicondyle height, ITB diameter (ITB-d), and ITB area (ITB-a). Results: Patients in the study group had significantly higher lateral epicondyle height (13.9 mm vs. 12.92 mm, P = 0.003), ITB-d (2.9 mm vs. 2.0 mm, P = 0.022), and ITB-a (38.5 mm2 vs. 23.8 mm2, P < 0.001) than the control group. ITB-a showed higher area under the curve index (0.849 with 74.1% sensitivity and 72.4% specificity at a 30.3 mm2 cutoff) than ITB-d (0.710 with 70.8% sensitivity and 61.2% specificity at 2.4 mm cutoff) and lateral epicondyle height (0.776 with 72.4% sensitivity and 67.8% specificity at 13.4 mm cutoff). However, only the inter-reader agreement for ITB-a (intraclass correlation coefficient = 0.65) was moderate, while the agreements for other morphologic features were good or excellent. Conclusions: Lateral epicondyle height seems to be a reliable and feasible morphologic feature for diagnosis of ITBFS.

Keywords

References

  1. Orava S. Iliotibial tract friction syndrome in athletes--an uncommon exertion syndrome on the lateral side of the knee. Br J Sports Med 1978; 12: 69-73. https://doi.org/10.1136/bjsm.12.2.69
  2. Khaund R, Flynn SH. Iliotibial band syndrome: a common source of knee pain. Am Fam Physician 2005; 71: 1545-50.
  3. Hong JH, Kim JS. Diagnosis of iliotibial band friction syndrome and ultrasound guided steroid injection. Korean J Pain 2013; 26: 387-91. https://doi.org/10.3344/kjp.2013.26.4.387
  4. Flato R, Passanante GJ, Skalski MR, Patel DB, White EA, Matcuk GR Jr. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skeletal Radiol 2017; 46: 605-22. https://doi.org/10.1007/s00256-017-2604-y
  5. Bankaoglu M, Mahmutoglu AS, Celebi I, Eren OT, Erturk SM, Kilic E, et al. Association of iliotibial band friction syndrome with patellar height and facets variations: a magnetic resonance imaging study. Iran J Radiol 2018; 15: e63459.
  6. Everhart JS, Kirven JC, Higgins J, Hair A, Chaudhari AA, Flanigan DC. The relationship between lateral epicondyle morphology and iliotibial band friction syndrome: a matched case-control study. Knee 2019; 26: 1198-203. Erratum in: Knee 2020; 27: 1291.
  7. Li J, Sheng B, Qiu L, Yu F, Lv FJ, Lv FR, et al. A quantitative MRI investigation of the association between iliotibial band syndrome and patellofemoral malalignment. Quant Imaging Med Surg 2021; 11: 3209-18. https://doi.org/10.21037/qims-20-1101
  8. Agridag Ucpinar B, Bankaoglu M, Eren OT, Erturk SM. Measurement of iliotibial band diameter in iliotibial band friction syndrome and comparison with an asymptomatic population. Acta Radiol 2021; 62: 1188-92. https://doi.org/10.1177/0284185120958407
  9. Park J, Cho HR, Kang KN, Choi KW, Choi YS, Jeong HW, et al. The role of the iliotibial band cross-sectional area as a morphological parameter of the iliotibial band friction syndrome: a retrospective pilot study. Korean J Pain 2021; 34: 229-33. https://doi.org/10.3344/kjp.2021.34.2.229
  10. Wibeeg G. Roentgenographs and anatomic studies on the femoropatellar joint: with special reference to chondromalacia patellae. Acta Orthop Scand 1941; 12: 319-410. https://doi.org/10.3109/17453674108988818
  11. Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971; 101: 101-4. https://doi.org/10.1148/101.1.101
  12. Shabshin N, Schweitzer ME, Morrison WB, Parker L. MRI criteria for patella alta and baja. Skeletal Radiol 2004; 33: 445-50. https://doi.org/10.1007/s00256-004-0794-6
  13. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012; 22: 276-82. https://doi.org/10.11613/BM.2012.031
  14. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-10. https://doi.org/10.1016/S0140-6736(86)90837-8
  15. Walbron P, Jacquot A, Geoffroy JM, Sirveaux F, Mole D. Iliotibial band friction syndrome: an original technique of digastric release of the iliotibial band from Gerdy's tubercle. Orthop Traumatol Surg Res 2018; 104: 1209-13. https://doi.org/10.1016/j.otsr.2018.08.013
  16. Foch E, Milner CE. Influence of previous iliotibial band syndrome on coordination patterns and coordination variability in female runners. J Appl Biomech 2019; 35: 305-11. https://doi.org/10.1123/jab.2018-0350
  17. Ekman EF, Pope T, Martin DF, Curl WW. Magnetic resonance imaging of iliotibial band syndrome. Am J Sports Med 1994; 22: 851-4. https://doi.org/10.1177/036354659402200619
  18. Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med 2000; 10: 169-75. https://doi.org/10.1097/00042752-200007000-00004
  19. Messier SP, Edwards DG, Martin DF, Lowery RB, Cannon DW, James MK, et al. Etiology of iliotibial band friction syndrome in distance runners. Med Sci Sports Exerc 1995; 27: 951-60. https://doi.org/10.1249/00005768-199507000-00002