Iliofemoral Ligament Inferior Band: Anatomy, Attachments, Relations, Function, Clinical Significance, MRI & CT Imaging

Topic

Iliofemoral Ligament inferior band (vertical band, medial band)

The iliofemoral ligament is the strongest ligament of the hip joint, and its inferior band, also known as the vertical band or medial band, provides vertical reinforcement to the anterior hip capsule. It runs almost straight from the pelvis to the femur and plays a crucial role in limiting hyperextension of the hip. The inferior band works in tandem with the superior band (oblique/lateral) to stabilize the anterior hip joint during weight bearing, gait, and standing posture.

Synonyms

Vertical band of iliofemoral ligament
Medial band of iliofemoral ligament
Inferior iliofemoral ligament

Attachments

Origin: Arises from the anterior inferior iliac spine (AIIS)
Course: Runs vertically downward and slightly medial, reinforcing the anterior hip joint capsule
Insertion: Attaches to the intertrochanteric line of the femur, closer to the medial end compared to the superior band

Relations

Anteriorly: Iliopsoas tendon and overlying femoral neurovascular bundle
Posteriorly: Hip joint capsule, femoral head and neck
Superiorly: Superior (oblique) band of iliofemoral ligament
Inferiorly: Pubofemoral ligament

Nerve Supply

Sensory innervation to the ligament and capsule via articular branches of the femoral nerve, obturator nerve, and sciatic nerve

Arterial Supply

Small capsular branches from the medial and lateral circumflex femoral arteries
Contributions from the obturator artery

Venous Drainage

Venous outflow parallels the arterial supply, draining into the femoral and obturator venous systems

Function

Provides vertical reinforcement to the anterior hip capsule
Prevents excessive hip hyperextension
Assists in stabilization during standing and maintains erect posture with minimal muscular effort
Contributes to anterior hip stability during walking and running

Clinical Significance

Critical structure in hip stability, particularly in extension
Injured in traumatic hip dislocations and hyperextension injuries
May show degeneration, thickening, or calcification in chronic hip pathology
Important surgical landmark during hip arthroscopy and joint replacement

MRI Appearance

T1-weighted images:

Inferior band appears as a thin, dark (low-signal) linear structure against bright pericapsular fat

T2-weighted images:

Appears as a dark, low-signal band
Tears, strain, or inflammation may cause focal bright signal within or around the ligament

STIR (Short Tau Inversion Recovery):

Ligament remains dark
Pathology (sprain, tear, inflammation) appears as bright hyperintense signal in or adjacent to ligament

T1 Fat-Sat Post-Contrast:

Normal ligament: no or minimal enhancement
Pathological ligament: focal or diffuse enhancement in sprain, capsulitis, or adjacent synovitis

CT Appearance

Non-Contrast CT:

Ligament itself not directly visualized; seen as a linear soft-tissue density within anterior hip capsule
Calcifications may appear at femoral insertion in chronic enthesopathy

Post-Contrast CT:

Ligament does not enhance
Adjacent synovial thickening, capsular inflammation, or periarticular tumor may show contrast enhancement
Hematoma or fluid in anterior recess can outline ligament better

MRI image

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