Female 58 years old Reason: lateral elbow synovitis History: pain Diluted gadolinium is noted within the elbow joint. Additionally, there is extensive gadolinium infiltrating the surrounding musculature and subcutaneous fat both anteriorly and posteriorly, likely iatrogenic, but limiting detailed evaluation. There is heterogeneity of the anterior fibers of the common extensor tendon representing a combination of tendinosis, partial thickness tearing, and prior intervention, improved from the prior examination. There are postsurgical changes involving the lateral compartment of the elbow with foci of susceptibility artifact from surgical material. Heterogenous signal and lower signal changes within the joint and olecranon fossa represents presumed scarring. No discrete loose joint bodies are identified within the pooled contrast and arthrogram. No frank signs of synovitis, yet more subtle changes prevent exclusion given the limitations described.Gadolinium is identified within the fibers of the lateral collateral ligament complex again suggests that there may be a defect. There is a small amount of marrow edema within the capitellum and proximal radius. Osteoarthritic changes affecting the radiocapitellar articulation are again noted with a stable subchondral cyst in the radial head. The ulnar collateral ligament and common flexor tendon appear intact. The ulnotrochlear articulation appears normal. As well again there may be some tendinosis of the common flexor tendon, though fibers remain intact. The biceps and biceps brachialis tendon appear normal. Evaluation of soft tissues changes in the surrounding anatomy is also limited especially for edema given gadolinium infiltration. The remaining visualized osseous structures and musculature is normal.
1. Limited evaluation due to extensive gadolinium infiltration. Postsurgical changes involving the lateral compartment. Gadolinium is identified within the fibers of the lateral collateral ligament complex suggesting that there may be a defect with accompanying mild marrow edema at this location. Heterogeneity of the common extensor tendon appears stable to slightly improved compared to the prior exam likely reflecting combination of tendinosis, partial thickness tearing, and prior intervention.2. Stable radiocapitellar osteoarthritis.