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Citation:
Feger J, Markhardt B, Worsley C, Black line sign. Reference article, Radiopaedia.org (Accessed on 05 Jun 2024) https://doi.org/10.53347/rID-83473
The black line sign refers to a hypointense linear area in the articular cartilage on magnetic resonance imaging, first described in the trochlear groove 1-3.
These lesions have been found also in all other regions of articular cartilage in the knee and not only on T2 weighted images but also in other sequences, e.g. fat-suppressed proton density-weighted images 4.
Correlation of these areas with arthroscopy showed that a significant number of hypointense signal linear or non-linear lesions corresponded to areas of cartilage degeneration 4.
Therefore, it has been suggested that the black line sign or focal areas of low signal intensity within otherwise healthy-appearing cartilage indicate areas of ‘fissuring’ or ’cartilage degeneration’ 1-4.
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1. Stephens T, Diduch D, Balin J, Gaskin C. The Cartilage Black Line Sign: An Unexpected MRI Appearance of Deep Cartilage Fissuring in Three Patients. Skeletal Radiol. 2011;40(1):113-6. doi:10.1007/s00256-010-0994-1 - Pubmed
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2. Wissman R, Ingalls J, Nepute J et al. The Trochlear Cleft: The “black Line” of the Trochlear Trough. Skeletal Radiol. 2012;41(9):1121-6. doi:10.1007/s00256-011-1356-3 - Pubmed
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3. Markhardt B & Chang E. Hypointense Signal Lesions of the Articular Cartilage: A Review of Current Concepts. Clin Imaging. 2014;38(6):785-91. doi:10.1016/j.clinimag.2014.05.002 - Pubmed
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4. Markhardt B & Kijowski R. The Clinical Significance of Dark Cartilage Lesions Identified on MRI. AJR Am J Roentgenol. 2015;205(6):1251-9. doi:10.2214/AJR.15.14409 - Pubmed
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