57-year-old female with lateral elbow pain for 2 years status post surgery Diluted gadolinium is noted within the elbow joint. Additional dilute gadolinium is noted infiltrating the triceps musculature and the subcutaneous fat posterior to the triceps as seen on the fluoroscopic arthrogram images, presumably iatrogenic. There is heterogeneity of the anterior fibers of the common extensor tendon likely representing a combination of tendinosis, partial-thickness tearing, and prior intervention. Although the majority of the lateral collateral ligament proper appears intact, gadolinium is identified within the anterior fibers of the common extensor tendon (presumably the extensor carpi radialis brevis) as well as along the myotendinous junction of the extensor carpi radialis brevis suggesting that there might be a small defect of the anterior fibers of the ligament itself. The lateral epicondyle itself appears normal. There are osteoarthritic changes affecting the radiocapitellar articulation which appear to have progressed slightly when compared to the prior study with a new subchondral cyst within the radial head. The ulnar collateral ligament and common flexor tendon appear normal as does the ulnotrochlear articulation. Other than the aforementioned iatrogenic infiltration, the triceps appears intact. The biceps and brachialis tendons appear normal. Gadolinium also courses along the ulnar nerve, but we suspect this is iatrogenic as well. The remaining of the visualized musculature is normal.
1. Heterogeneity of the anterior fibers of the common extensor tendon likely representing a combination of tendinosis, partial thickness tearing and prior intervention, which is comparable to that seen on the prior study from 10/13/2014 when accounting for differences in technique. Although the majority of the lateral collateral ligament appears intact, gadolinium is seen entering the anterior fibers of the common extensor tendon, suggesting a small defect in the anterior fibers of the ligament.2. Slight progression of radiocapitellar osteoarthritis.