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📌Hypointense Lesion in Cartilage
- Hypointense lesions in cartilage, known as cartilage dark lesions, are focal areas seen as low signal intensity on MRI.
- They are significant indicators of cartilage degeneration, often observed during knee arthroscopy.
✅ Characteristics and Detection
- Morphologically Normal Cartilage: These lesions have a 64% positive predictive value for degeneration detection at knee arthroscopy.
- Location and Appearance: Typically found in the middle zone, they can be linear or globular and are commonly associated with fibrillation or fissuring.
- Common Sites: Most commonly involve the femoral trochlea, lateral femoral condyle, and retropatellar areas.
- Arthroscopic Findings: Cartilage Degeneration: Represents areas with superficial and deep partial-thickness defects and fissuring.
✅ Composition and Signal Intensity
- Proteoglycan Concentration: Lesions are softer due to lower proteoglycan concentration and water content, seen in the central aspect of the trochlea.
- Chondrocalcinosis: Calcium pyrophosphate deposition may cause scattered, punctate, hypointense signal foci, best detected with gradient-echo MRI sequences.
✅ Mechanisms and Factors
- Tissue Anisotropy Disruption: Caused by increased exposure of "bound" protons on disrupted collagen to bulk water or mature fibrocartilage.
- Magic Angle Effect: Focal cartilage degeneration leads to losing the magic angle effect and more rapid T2 decay due to altered collagen fiber orientation.
✅ Pitfall
- Distinguishing from Normal Anisotropy: Radiologists must distinguish these areas from normal anisotropy patterns.
References
- RadioGraphics 2022; 42:1457–1473
- Semin Musculoskelet Radiol. 2021 Oct;25(5):690-699
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
© 2022 MSK MRI Jee Eun Lee All Rights Reserved.
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#CartilageLesion #MRI #ChondralDegeneration #KneeArthroscopy #CartilageFissuring #TissueAnisotropy #Chondrocalcinosis #Proteoglycan #MagicAngleEffect #RadiologyResearch
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