II. Indication

  1. Iliotibial Band Syndrome (refractory to other measures)

III. Preparation

  1. Needle: 25-27 gauge, 1 inch
  2. Corticosteroid options
    1. Betamethasone (Celestone) 0.5 to 1 ml of 6 mg/ml
    2. Methylprednisolone (Depo-Medrol): 0.5 to 1 ml of 40 mg/ml
    3. Dexamethasone 4 to 8 mg
    4. Triamcinolone 10 to 40 mg
  3. Anesthetic: 2 ml
    1. Lidocaine 1% OR
    2. Bupivacaine 0.25 or 0.5%

IV. Technique: Landmark

  1. Images
    1. OrthoKneeInjectIT.jpg
  2. Position patient
    1. Patient lies in lateral recumbent
    2. Knees flexed to 20 to 30 degrees
  3. Ultrasound (optional)
    1. Linear probe (12 MHz) applied in long axis over the IT Band
    2. Move the probe proximally until the lateral femoral condyle is in view
    3. Target pocket of fluid between IT Band and femoral condyle
  4. Identify Gerdy's Tubercle (Iliotibial band insertion)
    1. Bony prominence at anterior lateral condyle of tibia
    2. Lateral to distal margin of Patellar tendon
    3. Mark point of maximal tenderness
  5. Insert needle perpendicular to Gerdy's tubercle
    1. Insert to bone and withdraw 2-3 mm
    2. Inject Corticosteroid preparation

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