title: Proximal iliotibial band syndrome: what is it and where is it?
abstract: OBJECTIVE
  To describe the clinical and MR imaging features of a unique strain at the iliac tubercle enthesis. While this strain appeared to correspond to the iliotibial band (IT band) enthesis, the literature regarding the IT band origin was discrepant. As such, our second goal was to prove that the IT band originated at the iliac tubercle, through cadaveric dissection.
  
  
  METHODS
  Three musculoskeletal radiologists prospectively reviewed 67 consecutive bony pelvis MRI studies from October 2006 through September 2008 using either 3, 1.5, or 0.3 T units. Seven cases demonstrating strain at the iliac tubercle enthesis were identified and reviewed by consensus. History and patient demographics were reviewed. Cadaveric dissection was performed to delineate the anatomy of the proximal IT band.
  
  
  RESULTS
  Seven out of 67 individuals, all women, were identified with strain at the level of the iliac tubercle (prevalence 10%). Four of seven were athletes, three were overweight. Patients presented with pain and tenderness at the iliac tubercle. Anatomic dissection confirmed that iliotibial band originates along the margin of the iliac crest with dominant fibers condensing on the iliac tubercle.
  
  
  CONCLUSIONS
  Proximal IT band strain represents a unique injury that should be considered in patients who are female athletes or older overweight women who present with pain and tenderness at the iliac tubercle. Imaging of this entity must include the iliac tubercle, which is often excluded in standard hip MRI.
authors.affiliation: Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY 10461, USA. irene.sher@hotmail.com
authors.forename: Irene
authors.initials: I
authors.lastname: Sher
authors.forename: Hilary
authors.initials: H
authors.lastname: Umans
authors.forename: Sherry A
authors.initials: SA
authors.lastname: Downie
authors.forename: Keith
authors.initials: K
authors.lastname: Tobin
authors.forename: Ritika
authors.initials: R
authors.lastname: Arora
authors.forename: Todd R
authors.initials: TR
authors.lastname: Olson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001265:Athletic Injuries / Q000175:diagnosis*; D002102:Cadaver; D004210:Dissection; D005205:Fascia / Q000293:injuries; D005260:Female; D006801:Humans; D058745:Iliotibial Band Syndrome / Q000175:diagnosis*; D007085:Ilium / Q000033:anatomy & histology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000293:injuries