 In the last case, we saw a little divot in the trochlea here that was an osteocondylesion. Well, here's another case of a little divot, but this is a much more serious condition. This is a result of avascular necrosis to the trochlea, which causes a fishtail deformity of the elbow. They call it a fishtail is because both the condyles come down, like so and like so, and I'll draw that for you in a little bit, looking like the tail of a fish. What's happening? So the history here is very, very important. This person, maybe four or five years ago, had a supercondyler fracture. Remember we talked about a supercondyler fracture? Where does it happen? Right here, where the bone is very, very thin. So at one point, this person had a supercondyler fracture. It healed up. But then a few years later, he started having pain. And when we re-imaged them, this is an arthrogram, this is a T1 weighted sequence with intraarticular contrast. This is a death sequence, and that's fluid over here. When we did this, we saw this big divot over here. And we also saw osteocondrolesions involving the radius here, the capitellum over here, and also parts of the trochlea. So multi-focal areas of osteocondrolesion and cystic changes and degeneration and even a little bit osteophyte formation. So these are all sequela of long-term abnormality in that joint because of incongruity and avascular necrosis in the lateral trochlea. And on the lateral view, on the sagittal view, you can see there's even a little bit of cartilage fissuring that's happening over here, all part of this entire process. And it all stemmed from the fact that this person years ago had a supercondyler fracture, something that's very, very common in kids. But not everybody who has this fracture goes on to develop this abnormality or this complication. It's rare, but it's important enough that a good orthopedic surgeon will say to the child's mother or the child, hey, you know what, your elbow is probably going to be fine after the supercondyler fracture. But in a few years, if you start having pain for no apparent reason, come back and see me because this could be one of those complications that's happening. In the next vignette, I'm going to show you why this happens.