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High-resolution ultrasound of the fascia lata iliac crest attachment: anatomy, pathology, and image-guided treatment

  • Swati Deshmukh
  • Samir F. Abboud
  • Thomas Grant
  • Imran M. Omar
Review Article
  • 45 Downloads

Abstract

Pathology of the fascia lata attachment at the iliac crest (FLAIC) is an under-recognized and often misdiagnosed cause of lateral hip pain. The fascia lata has a broad attachment at the lateral iliac crest with contributions from the tensor fascia lata muscle, the iliotibial band, and the gluteal aponeurosis. The FLAIC is susceptible to overuse injuries, acute traumatic injuries, and degeneration. There is a paucity of literature regarding imaging and image-guided treatment of the FLAIC. We review anatomy and pathology of the FLAIC, presenting novel high-resolution (18–24 MHz) ultrasound images including ultrasound guidance for targeted therapeutic treatment.

Keywords

Fascia lata Iliotibial band Tensor fascia lata Gluteal aponeurosis Ultrasound 

Notes

Acknowledgements

The authors would like to acknowledge Julia Michalek, musculoskeletal sonographer, for her invaluable contributions to this paper.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Huang BK, Campos JC, Ghobrial P, et al. Injury of the gluteal aponeurotic fascia and proximal iliotibial band: anatomy, pathologic conditions, and MR imaging. Radiographics. 2013;33:1437–52.CrossRefGoogle Scholar
  2. 2.
    Bass CJ, Connell DA. Sonographic findings of tensor fascia lata tendinopathy: another cause of anterior groin pain. Skelet Radiol. 2002;31:143–8.CrossRefGoogle Scholar
  3. 3.
    Lungu E, Michaud J, Bureau NJ. US assessment of sports-related hip injuries. Radiographics. 2018;38:867–89.CrossRefGoogle Scholar
  4. 4.
    Sher I, Umans H, Downie SA, et al. Proximal iliotibial band syndrome: what is it and where is it? Skelet Radiol. 2011;40:1553–6.CrossRefGoogle Scholar
  5. 5.
    Decker G, Hunt D. Proximal iliotibial band enthesopathy in a runner: a case report. PM R. 2018.  https://doi.org/10.1016/j.pmrj.2018.06.017.
  6. 6.
    Patel Am Helm ER. Poster 127. Proximal iliotibial band rupture secondary to chronic steroid use: a case report. Abstracts. PM R. 2016:S151–332.Google Scholar
  7. 7.
    Flato R, Passanante GJ, Skalski MR, et al. The iliotibial tract: imaging, anatomy, injuries, and other pathology. Skelet Radiol. 2017;46:605–22.CrossRefGoogle Scholar
  8. 8.
    Benjamin M. The fascia of the limbs and back—a review. J Anat. 2009;214(1):1–18.CrossRefGoogle Scholar
  9. 9.
    Trammell AR, Pilson H. Anatomy, lower limb, thigh, muscles, tensor fasciae latae. NCBI Bookshelf. StatPearls. 2018.Google Scholar
  10. 10.
    Pan J, Bredella MA. Imaging lesions of the lateral hip. Semin Musculoskelet Radiol. 2013;17(3):291–305.CrossRefGoogle Scholar
  11. 11.
    Chiavaras MM, Jacobson JA. Ultrasound-guided tendon fenestration. Semin Musculoskelet Radiol. 2013;17(1):85–90.CrossRefGoogle Scholar
  12. 12.
    Daniels EW, Cole D, Jacobs B, et al. Existing evidence on ultrasound-guided injections in sports medicine. Orthop J Sports Med. 2018;6(2):2325967118756576.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Adler RS, Sofka CM. Percutaneous ultrasound-guided injections in the musculoskeletal system. Ultrasound Q. 2003;19(1):3–12.CrossRefGoogle Scholar
  14. 14.
    Sofka CM, Adler RS. Ultrasound-guided interventions in the foot and ankle. Semin Musculoskelet Radiol. 2002;6(2):163–8.CrossRefGoogle Scholar
  15. 15.
    Drakonaki EE, Allen GM, Watura R. Ultrasound-guided intervention in the ankle and foot. Br J Radiol. 2016;89(1057):20150577.CrossRefGoogle Scholar
  16. 16.
    McNally EG, Shetty S. Plantar fascia: imaging diagnosis and guided treatment. Semin Musculoskelet Radiol. 2010;14(3):334–43.CrossRefGoogle Scholar
  17. 17.
    Bradberry DM, Sussman WI, Mautner K. Ultrasound-guided percutaneous needle tenotomy for chronic tensor fascia lata tendinopathy: a case series and description of sonographic findings. PM R. 2018;10:979–83.CrossRefGoogle Scholar

Copyright information

© ISS 2019

Authors and Affiliations

  • Swati Deshmukh
    • 1
  • Samir F. Abboud
    • 1
  • Thomas Grant
    • 1
  • Imran M. Omar
    • 1
  1. 1.Northwestern Memorial Hospital/Northwestern UniversityChicagoUSA

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