Dr. Joseph Gagliardi responds:

Osseous geodes are seen in several articular disorders, such as osteoarthritis, CPPD, and rheumatoid arthritis. On routine radiographs these appear to be subarticular, well-defined lucent areas and commonly have a sclerotic margin. On MR, these are low in signal on T-1 sequences; they increase in signal with T-2 and STIR sequences. Yes, these lesions can show mild enhancement following Gadolinium administration. Articular disease, multiple lesions, subchondral location, and other manifestations of an articular disease help avoid confusion with other entities.