A 23-year-old male infantry soldier presented to a direct-access physical therapy clinic with a complaint of persistent left knee pain. Observation revealed mild left quadriceps atrophy and left knee effusion. The patient's gait was mildly antalgic and a small, mobile, hard palpable mass was protruding at the medial joint line during gait. Due to the increased frequency of the patient's left knee giving way and the presence of a palpable mass along the medial joint line of the left knee, knee radiographs were ordered. The radiographs demonstrated abnormal contour of the medial femoral condyle, consistent with an osteochondral defect, and a fabella posterior to the knee. Based on the patient's antalgic gait and radiographic findings, the patient was instructed on the proper use of crutches and referred to an orthopaedic surgeon for appropriate management. While the irregular contour of the medial femoral condyle was readily apparent in this patient's images, radiographs may not always adequately show osteo...