Friction syndrome

Last revised by Dr Joachim Feger on 07 Dec 2021

A friction syndrome is a form of overuse injury caused by repetitive scouring between tendinous and bony structures or different tendons.

Usually, young adults and athletes are affected but they can occur at any age.

Friction syndromes usually present with pain at the respective location and in some friction syndromes snapping is a typical phenomenon.

As a result of overuse, the tissues affected by repetitive compression and gliding mechanisms become inflamed and edematous leading to even more friction 1.

Typical locations, where tendons slide over bony prominences or where tendons glide past each other include 1:

Hyperemia on color Doppler 1.

MRI might demonstrate soft-tissue edema at typical locations or bursal collections with surrounding edema and/or bone marrow edema in the adjacent and affected osseous structures 1.

  • T1: mildly hypointense
  • T2FS/PDFS: diffuse hyperintense
  • T1 C+: mild enhancement

Treatment depends on the location but typically include exercise therapy, activity modification taping, physical and manual therapy as well as orthotic management 3 and nonsteroidal anti-inflammatory drugs or immobilization 4. Surgery is usually reserved for cases, failing different approaches of conservative management 4,5.

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Cases and figures

  • Case 1: iliotibial band friction syndrome
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  • Case 2: patellar tendon lateral femoral condyle friction syndrome
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  • Case 3: proximal intersection syndrome
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  • Case 4: distal intersection syndrome
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