II. Indication
- Iliotibial Band Syndrome (refractory to other measures)
III. Preparation
- Needle: 25-27 gauge, 1 inch
-
Corticosteroid options
- Betamethasone (Celestone) 0.5 to 1 ml of 6 mg/ml
- Methylprednisolone (Depo-Medrol): 0.5 to 1 ml of 40 mg/ml
- Dexamethasone 4 to 8 mg
- Triamcinolone 10 to 40 mg
-
Anesthetic: 2 ml
- Lidocaine 1% OR
- Bupivacaine 0.25 or 0.5%
IV. Technique: Landmark
- Images
- Position patient
- Patient lies in lateral recumbent
- Knees flexed to 20 to 30 degrees
-
Ultrasound (optional)
- Linear probe (12 MHz) applied in long axis over the IT Band
- Move the probe proximally until the lateral femoral condyle is in view
- Target pocket of fluid between IT Band and femoral condyle
- Identify Gerdy's Tubercle (Iliotibial band insertion)
- Bony prominence at anterior lateral condyle of tibia
- Lateral to distal margin of Patellar tendon
- Mark point of maximal tenderness
- Insert needle perpendicular to Gerdy's tubercle
- Insert to bone and withdraw 2-3 mm
- Inject Corticosteroid preparation
V. References
- Pfenninger (1994) Procedures, p. 1036-54
- Cardone (2003) Am Fam Physician 67(10):2147-52 [PubMed]
- Zuber (2002) Am Fam Physician 66(8):1497-1500 [PubMed]