26 year old male status post olecranon osteotomy for osteochondral defect, compare cartilage surface with previous exams. Review of the patient's first mri examinations reveals a subchondral lesion within the distal humerus centrally compatible with a "trochlear osteochondral defect," which has since undergone surgery (bone grafting). The majority of the defect is now filled with signal intensity similar to normal bone marrow with exception of a 5-mm subchondral focus of low signal intensity centrally that appears identical to prior. Irregularity of overlying articular surface with overlying cartilage loss also appears similar to prior. There is a small focus of abnormal signal intensity within the trochlear groove of the olecranon in the approximate location of the trochlear ridge that was not seen on prior examination. This could represent a small degenerative subchondral cyst. There is also mild focal edema-type signal within the medial aspect of the olecranon process and the posterior aspect of the medial humeral condyle with small osteophytes, suggesting a degenerative etiology, which may be associated with overlying focal cartilage loss.No loose bodies in the joint. No joint effusion.Low signal intensity within the posterolateral aspect of the radiocapitellar articulation may represent a prominent radiohumeral plica, which can be associated with "synovial fringe syndrome" in the correct clinical context (posterolateral pain and/or mechanical symptoms).Remainder of the soft tissue structures are normal.
1.Postoperative changes of distal humeral trochlear osteochondral defect bone grafting, appearing similar to prior.2.New small foci of signal abnormality within the trochlear groove of the olecranon and along the medial aspect of the ulnohumeral articulation, which could be degenerative in etiology.3.Findings suggestive of a prominent radiohumeral plica, which can be associated with "synovial fringe syndrome" in the correct clinical context (posterolateral pain and/or mechanical symptoms).