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Eur Radiol. 2016 Jul;26(7):2387-99. doi: 10.1007/s00330-015-4027-2. Epub 2015 Sep 29.

T2 black lesions on routine knee MRI: differential considerations.

Author information

1
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
2
Musculoskeletal Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
3
Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
4
Musculoskeletal Radiology, UT Southwestern Medical Center, Dallas, TX, USA. avneesh.chhabra@utsouthwestern.edu.
5
Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA. avneesh.chhabra@utsouthwestern.edu.

Abstract

The majority of abnormal findings or lesions on T2-weighted fast spin-echo (FSE) magnetic resonance imaging (MRI) are hyperintense due to increased perfusion or fluid content, such as infections, tumours or synovitis. Hypointense lesions on T2-weighted images (both fat-suppressed and non-fat-suppressed) are less common and can sometimes be overlooked. Such lesions have limited differential diagnostic possibilities, and include vacuum phenomenon, loose body, tenosynovial giant cell tumour, rheumatoid arthritis, haemochromatosis, gout, amyloid, chondrocalcinosis, hydroxyapetite deposition disease, lipoma arborescens, arthrofibrosis and iatrogenic lesions. These lesions often show characteristic appearances and predilections in the knee. In this article, the authors describe the MRI features of hypointense T2 lesions on routine knee MRI and outline a systematic diagnostic approach towards their evaluation. Key Points • Hypointense lesions on T2 images (T2 Dark Lesions) encompass limited diagnostic possibilities. • T2 Dark lesions often show characteristic appearances and predilections in the knee. • A systematic diagnostic approach will help radiologists make the correct diagnosis.

KEYWORDS:

Arthrofibrosis; Chondrocalcinosis; Chondromatosis; MRI knee; Tenosynovial giant cell tumour

PMID:
26420500
DOI:
10.1007/s00330-015-4027-2
[Indexed for MEDLINE]

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