MRI of the Normal Elbow and Common Pathologic Conditions

Imaging Review of Different Subchondral Insufficiency Fractures

“…[14][15][16] This occurs through an inside-out mechanism that begins with damage deep to the articular surface, most commonly at the anterolateral aspect of the capitellum, and may ultimately culminate in separation and detachment of the osteochondral fragment. 14,17 Clinically, patients typically present with a progressive increase in activity-related elbow pain, tenderness laterally, or stiffness and loss of forearm extension.…”

“…Radiographic evaluation will show irregularity of texture in the epiphysis of the capitellum, 20 while MRI demonstrates low T1 signal and edema-like signal on fluid-sensitive sequences throughout the capitellum. 17 Pseudodefect of the capitellum is in the radiologic differential of Panner's disease and capitellar OCD but can be identified by its characteristic location at the posterior margin of the capitellum and lack of associated bone marrow edema. This is a self-limiting condition and treatment is generally conservative.…”

“…Because it is commonly seen in young athletes with a history of repetitive valgus stress, it is thought to represent an overuse injury of subchondral bone with fragmentation of the overlying articular cartilage 14–16 . This occurs through an inside-out mechanism that begins with damage deep to the articular surface, most commonly at the anterolateral aspect of the capitellum, and may ultimately culminate in separation and detachment of the osteochondral fragment 14,17 …”