Journal of Osteoporosis and Physical Activity
Open Access

Abstract

Unique Case of Iliotibial Band Dehiscence: Focal Cystic Network at the Lateral Distal Thigh ??? Can Fluid Pressure Tear?

Dr. Rosalyn Nguyen

The patient was a healthy 46-year-old male who presented with intermittent, dull-aching right lateral lower thigh/knee pain of 3 months, worse with running, jumping, and squatting. He noticed a focal protrusion in the lateral lower thigh above the lateral knee that diminished, but then returned and progressed. He was a former soccer player and had been exercising 4 days a week about half an hour each time, using ellipticals, weights, and P90X variations. He had been running on his treadmill regularly at the time of onset of symptoms. Physical exam revealed a focal protrusion at the distal lateral right thigh superior to the lateral joint line. There was focal tenderness. Other knee and leg tests were benign. MSK Ultrasound showed right ITB dehiscence and cystic fluid collections interconnected with a superficial and deep network. MRI of the right knee showed a 1.8 x 2.9 x 1.0 cm multilobulated extracapsular cystic structure projects lateral to the posterior lateral femoral condyle, compatible with a ganglion cyst. 1.0 x 0.7 x 1.1 cm portion of the cyst appears to extend through a 2 mm dehiscence in the posterior aspect of the iliotibial and extending into the lateral subcutaneous fat. We present an interesting case of a network of ganglion cysts that had pushed out and likely subsequently led to a focal ITB dehiscence. Symptoms and cysts improved with ultrasound guided aspirations. Upon repetitive recurrences, it eventually required surgery. There were no significant knee issues thereafter for the next 1.5 years and he returned to athletic activities

Published Date: 2020-08-31;