Korean J Radiol.  2015 Feb;16(1):169-174. 10.3348/kjr.2015.16.1.169.

Intra-Articular Fibroma of Tendon Sheath in a Knee Joint Associated with Iliotibial Band Friction Syndrome

• Ha DH
• Choi S
• Kim SJ
• Lih W

• KMID: 2069996
• DOI: http://doi.org/10.3348/kjr.2015.16.1.169

Abstract

Iliotibial band (ITB) friction syndrome is a common overuse injury typically seen in the active athlete population. A nodular lesion on the inner side of the ITB as an etiology or an accompanying lesion from friction syndrome has been rarely reported. A 45-year-old male presented with recurrent pain and a movable nodule at the lateral joint area, diagnosed as ITB friction syndrome. The nodule was confirmed as a rare intra-articular fibroma of the tendon sheath (FTS) on the basis of histopathologic findings. We describe the MRI findings, arthroscopic and pathologic features, in this case of intra-articular FTS presenting with ITB friction syndrome.

Keyword

Iliotibial band friction syndrome; Fibroma of tendon sheath; Knee; Magnetic resonance imaging

MeSH Terms

Cumulative Trauma Disorders/complications/*diagnosis
Fibroma/*etiology
Friction
Humans
Iliotibial Band Syndrome/complications/*diagnosis
Knee Joint/*pathology
Magnetic Resonance Imaging
Male
Middle Aged
Pain/etiology
Tendons/*pathology

Figure

• 

  Fig. 1 45-year-old male presented with recurrent lateral knee pain and movable nodule. A. Coronal fat suppressed proton density weighted image (repetition time [TR] 1700 ms, echo time [TE] 10 ms) shows thickened iliotibial band (ITB), high signal intensity (SI) fatty abnormalities deep to ITB, and slight high SI nodule with thin rim (arrow). B. Coronal T1-weighted image (TR 400 ms, TE 20 ms) reveals low SI lesion (arrow) compared to adjacent fat and iso-SI compared to knee muscle. C. Axial T2-weighted image (TR 3200 ms, TE 100 ms) shows high SI nodule (arrow). D, E. Arthroscopic examination shows presence of inflamed lateral synovial recess (D) and whitish polypoid intraarticular nodule (E) attached to joint capsule. F, G. Resected fibrous nodule (F, H&E staining, × 10) composes of collagen fibers and scattered fibroblasts (G, H&E staining, × 200). H. Resected adjacent tissues show fibrosis, marked hemorrhage, and prominent capillary proliferation (H&E staining, × 30).

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