case_images: PMC3738356_01
case_images: Lateral (a) and anteroposterior (b) views of Twin A. Subtle lucency and capitellar subchondral changes are seen (black arrows in (a) and (b)). Intra-articular loose bodies (white arrows in (a) and (b)) and joint effusion (white arrowhead in (a)) are present
case_images: 10.1258_arsr.2012.120004-fig1.jpg
case_images: PMC3738356_01_10.1258_arsr.2012.120004-fig1.jpg
case_images: ARSR-12-0004F1
case_images: Radiographs (Figs. 1 and 2) showed some flattening and subchondral lucencies of the articular surface of the capitellum in both patients.
case_images: Lateral (a) and anteroposterior (b) views of Twin B. Subtle lucency in capitellar subchondral bone is seen (black arrows in (a) and (b)). There is a small osteochondral fragment on the anterior portion of the distal capitellar surface (black arrowheads in (a) and (b)). There are also intra-articular loose bodies (white arrows in (a) and (b)) and joint effusion (white arrowhead in (a)). Early osteophyte formation is seen on the medial side of the ulna (curved black arrow in (b))
case_images: 10.1258_arsr.2012.120004-fig2.jpg
case_images: PMC3738356_01_10.1258_arsr.2012.120004-fig2.jpg
case_images: ARSR-12-0004F2
case_images: Radiographs (Figs. 1 and 2) showed some flattening and subchondral lucencies of the articular surface of the capitellum in both patients.
case_images: MR images of Twin A. Coronal T2-weighted fat-suppressed spin echo (a), coronal PD spin echo (b), and sagittal T2-weighted fat-suppressed spin echo (c). Subchondral edema in the capitellum (white arrow in (a)) with overlying bony defects and cartilage defect of the capitellum (black arrows in (b) and (c)) are seen (Stage II). There are loose bodies (white arrowhead in (a) and (c)) in the joint. On the ulnar side, osteophyte formation is recognized (white curved arrows in (a) and (b))
case_images: 10.1258_arsr.2012.120004-fig3.jpg
case_images: PMC3738356_01_10.1258_arsr.2012.120004-fig3.jpg
case_images: ARSR-12-0004F3
case_images: Twin A (Fig. 3) had cartilage defects, bone marrow edema, and osseous changes in the capitellum.
case_images: MR images of Twin B. Coronal T2-weighted fat-suppressed spin echo (a), coronal PD spin echo (b), and sagittal T2-weighted fat-suppressed spin echo (c). Subchondral bony defects in the capitellum (black arrow in (b)) with small T2 hyperintense rim surrounding the chondral lesion (white arrows in (b) and (c)) are seen. Loose bodies (white arrowheads in (a) and (b)) are both in the posterior joint recess and in the radiohumeral joint. Loose bodies and fluid insinuation between the osteochondritis dissecans lesion and parent bone are features of instability (Stage III)
case_images: 10.1258_arsr.2012.120004-fig4.jpg
case_images: PMC3738356_01_10.1258_arsr.2012.120004-fig4.jpg
case_images: ARSR-12-0004F4
case_images: Twin B (Fig. 4) had joint effusion and intra-articular loose bodies.
case_images: An anterolateral arthroscopic image of Twin A (a) showed slightly irregular surface of capitellum (white arrow in (a)). Removed osteochondral loose bodies (b)
case_images: 10.1258_arsr.2012.120004-fig5.jpg
case_images: PMC3738356_01_10.1258_arsr.2012.120004-fig5.jpg
case_images: ARSR-12-0004F5
case_images: Twin A had a mild synovitis, and loose bodies were detected (Fig. 5).
case_images: An anterolateral arthroscopic image of Twin B elbow (a) showed irregular surface of capitellum (white arrow in (a)), which was more severe than in Twin A. Some fraying is also seen in the radiocapitellar joint space (black arrow in (a)). Removed osteochondral loose bodies (b)
case_images: 10.1258_arsr.2012.120004-fig6.jpg
case_images: PMC3738356_01_10.1258_arsr.2012.120004-fig6.jpg
case_images: ARSR-12-0004F6
case_images: Twin B also had mild synovitis and loose bodies (Fig. 6).