Osteochondral lesions in the radiocapitellar joint in the skeletally immature: radiographic, MRI, and arthroscopic findings in 13 consecutive cases.

Radiography, magnetic resonance imaging (MRI), and arthroscopy were performed in 13 consecutive cases of osteochondral lesions of the radiocapitellar joint in 12 patients aged 11-16 years. Nine patients had a high activity level, and two patients had a significant trauma before the onset of symptoms. Symptoms were limited range of motion, pain, and catchings or lockings. Clinical findings were decreased range of motion and lateral elbow tenderness. Radiography revealed loose body, flattening of the humeral capitellum, or subchondral cysts (or a combination of these) in all cases but three. There was a good correlation between MRI and arthroscopic examination. Nine lesions were located in the humeral capitellum, one lesion in the radial head, and in three cases, lesions were found in both sites. Loose-body removal, shaving, or subchondral drilling (or a combination of these) was performed in 11 cases. All surgically treated patients improved in the short run. Awareness of the typical clinical and radiologic picture will allow identification of the cases suitable for arthroscopy and surgical treatment. In these cases, MRI can be omitted.