A 13-year-3-month-old female with FOPE zones at both proximal tibiae. Findings: coronal proton density fat-saturated image from right knee MRI obtained 9 months after initial presentation shows an osteochondral lesion (arrow) with mild surrounding marrow edema (asterisk) of the medial femoral condyle corresponding to subtle lytic lesion present on initial radiographs. Technique: coronal PD fat-saturated MRI (TR = 2,825.7, TE = 30), ST = 2.5 mm, spacing = 3.264 mm, FOV = 14 cm, and matrix = 312 × 244.