Yuugi's horn is on the steps. This may have been painful. Reimu and/or Sanae, Suwako, Shou, Cirno, Kanako and Eirin seem to have visited recently as well.
Is there a tag for the crystals floating above Patchouli? I've seen them in other images as well.
I doubt that since Marisa first met with patchy at the time of SDM and they didn't knew each other,also kourin was the one who gave marisa the hakkero so its far from been true.