40 year old female with clicking on range of motion. Evaluate for loose bodies. LIGAMENTS: There is linear intermediate signal intensity partially separating the distal fibers of the ulnar collateral ligament from the sublime tubercle of the coronoid process which may represent a partial undersurface tear of uncertain current clinical significance. The radial collateral ligament appears intact. The lateral ulnar collateral ligament appears intact.TENDONS: There is thickening and heterogeneity of signal of the common flexor tendon at its origin compatible with chronic tendinosis, but we see no fluid signal intensity within the tendon to indicate a tear. There are small foci of signal void adjacent to the tendon as well as bandlike scarring in the overlying subcutaneous fat, suggesting prior surgery to this area. The common extensor tendon appears intact. The biceps and brachialis tendons appear intact. The triceps tendon appears intact.ARTICULAR SURFACES AND BONE: There is edema type signal abnormality within the distal humerus concentrated in the capitellum. There is curvilinear subchondral fluid signal intensity within the anterior margin of the capitellum indicating a subchondral fracture. The articular surface fracture fragment is in near-anatomic alignment at this time. There is low signal intensity of the bone underneath the subchondral fracture which likely represents sclerosis. These findings are compatible with osteonecrosis.ADDITIONAL
1. Avascular necrosis of the capitellum of the distal humerus with large subchondral fracture. The articular surface fragment is in near-anatomic alignment at this time.2. Moderate-sized elbow joint effusion. Although we see no definite loose body within the joint, we cannot completely exclude the possibility of a cartilaginous loose body adherent to the capsule as described above.3. Postoperative changes of prior ulnar nerve transposition.4. Tendinosis of the common flexor tendon.5. Partial undersurface tear of the ulnar collateral ligament as described above, of questionable clinical significance.