A friction syndrome is a form of overuse injury caused by repetitive scouring between tendinous and bony structures or different tendons.
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Epidemiology
Usually, young adults and athletes are affected but they can occur at any age.
Clinical presentation
Friction syndromes usually present with pain at the respective location and in some friction syndromes snapping is a typical phenomenon.
Pathology
As a result of overuse, the tissues affected by repetitive compression and gliding mechanisms become inflamed and oedematous leading to even more friction 1.
Location
Typical locations, where tendons slide over bony prominences or where tendons glide past each other include 1:
- iliotibial band friction syndrome
- patellar tendon-lateral femoral condyle friction syndrome
- posteromedial knee friction syndrome
- medial tibial crest friction syndrome
- proximal and distal intersection syndrome
- plantaris friction syndrome
Radiographic features
Ultrasound
Hyperaemia on colour Doppler 1.
MRI
MRI might demonstrate soft-tissue oedema at typical locations or bursal collections with surrounding oedema and/or bone marrow oedema in the adjacent and affected osseous structures 1.
Signal characteristics
- T1: mildly hypointense
- T2FS/PDFS: diffuse hyperintense
- T1 C+: mild enhancement
Treatment and prognosis
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 immobilisation 4. Surgery is usually reserved for cases, failing different approaches of conservative management 4,5.
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