Ultrasound-Guided Iliotibial Band Hydro-Dissection Using 5% Dextrose: A Novel Treatment Approach

Background: Iliotibial band syndrome (ITBS) is a common cause of lateral thigh and knee pain, particularly in physically active individuals. Conservative management including physiotherapy, rest, and oral analgesia may fail to adequately control symptoms in a subset of patients. Ultrasound-guided hydro-dissection is a minimally invasive technique involving injection of fluid to separate fascial planes and release adhesions surrounding nerves, tendons, and soft tissue structures. While hydro dissection has been increasingly described in peripheral nerve entrapment syndromes, its application in iliotibial band syndrome has not previously been well reported. Case Presentation: We present the case of a 48-year-old male with chronic refractory left lateral thigh pain secondary to iliotibial band syndrome. Conservative management including physiotherapy and analgesic medications had failed to provide sustained symptom relief. Ultrasound examination demonstrated pathological changes along the iliotibial band with associated soft tissue adhesions. Intervention: Ultrasound-guided hydro-dissection of the iliotibial band was performed using 5% dextrose solution (10 mls) under direct ultrasound visualization. The procedure aimed to mechanically separate fascial adhesions and improve tissue gliding within the affected region. Results: The patient reported significant improvement in pain and functional mobility following the procedure, with sustained benefit at two-month follow-up. No immediate or delayed complications were observed. Conclusion: This case demonstrates the potential role of ultrasound-guided dextrose hydro dissection as a minimally invasive treatment option for refractory iliotibial band syndrome. Further studies are required to evaluate its efficacy and long-term outcomes.