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Tensor fasciae latae tendon

The tensor fasciae latae (TFL) tendon is the proximal tendinous portion of the tensor fasciae latae muscle, a small but functionally significant muscle located on the lateral aspect of the thigh. The tendon arises from the anterior iliac crest and anterior superior iliac spine (ASIS) before transitioning into the muscle belly and then blending distally into the iliotibial band (ITB).

The TFL tendon plays a major role in initiating tension into the ITB, thereby contributing to lateral stabilization of the hip and knee joints. It is clinically relevant in overuse injuries, iliotibial band syndrome, tendinopathy, and surgical approaches to the lateral hip.

Synonyms

  • TFL tendon

  • Tensor of fascia lata tendon

  • Iliotibial band origin tendon

Origin and Insertion

  • Origin (tendinous portion): Arises from the outer lip of the iliac crest, the lateral surface of the anterior superior iliac spine (ASIS), and the deep fascia of the gluteus medius

  • Course: Short tendon that quickly transitions into the muscular belly of the tensor fasciae latae, which then passes downward and laterally over the anterolateral thigh

  • Insertion: Distally, the tendon-muscle complex inserts into the iliotibial band, which continues to the lateral condyle of the tibia (Gerdy’s tubercle)

Nerve Supply

  • Superior gluteal nerve (L4–S1)

Arterial Supply

  • Superior gluteal artery (primary supply)

  • Lateral circumflex femoral artery (branch of profunda femoris)

Venous Drainage

  • Corresponding veins drain into the superior gluteal vein and the femoral vein system

Function

  • Provides tension to the iliotibial band, aiding lateral stabilization of the hip and knee

  • Assists in hip abduction, flexion, and medial rotation

  • Helps stabilize the pelvis during gait and upright posture

  • Plays a role in dynamic stabilization of the knee, particularly during running and single-leg stance

Clinical Significance

  • Involved in iliotibial band syndrome due to overuse

  • Can develop tendinopathy or partial tears from repetitive hip/knee movements

  • Landmark in lateral hip surgical approaches

  • Overactivity or shortening may contribute to patellofemoral pain syndrome or lateral knee pain

MRI Appearance

T1-weighted images:

  • Tendon appears as a low-signal intensity band arising from ASIS/iliac crest

  • Surrounded by bright subcutaneous fat, providing contrast

T2-weighted images:

  • Tendon remains dark (low signal)

  • Partial tears or tendinopathy appear as focal bright areas within or around the tendon

STIR (Short Tau Inversion Recovery):

  • Normal tendon remains dark

  • Edema, strain, or peritendinous inflammation appears bright hyperintense

Proton Density Fat-Saturated (PD FS):

  • Tendon shows low signal in normal state

  • Pathology (strain, tendinopathy, partial tear) appears as bright focal hyperintensity

T1 Fat-Sat Post-Contrast:

  • Normal tendon shows little or no enhancement

  • Inflamed or pathologic tendon may show focal or diffuse enhancement, particularly at enthesis (bony attachment)

CT Appearance

Non-Contrast CT:

  • Tendon appears as a thin soft tissue density near ASIS

  • Best differentiated by adjacent fat planes

  • Calcific tendinopathy may appear as high-density foci

Post-Contrast CT:

  • Normal tendon does not enhance

  • Surrounding soft tissue enhancement may be seen in cases of tendinitis, bursitis, or adjacent inflammation

MRI image

Tensor fasciae latae tendon MRI axial anatomy image-img-00000-00000

MRI image

Tensor fasciae latae tendon MRI axial anatomy image-img-00000-00000_00001

MRI image

Tensor fasciae latae tendon MRI axial anatomy image-img-00000-00000_00002

CT image

Tensor Fasciae Latae Tendon ct axial