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This study presents three cases demonstrating transient intra-articular gas that simulated meniscal pathology but was ultimately identified as a benign vacuum phenomenon. We describe a novel diagnostic clue, the \u201crising tide sign,\u201d which refers to the progressive disappearance of intra-articular gas and the posterior-to-anterior migration of the fluid interface in a gravity-dependent manner, resembling rising tidal water. Recognition of this sign enables differentiation between true meniscal tears and gas artifacts, thereby avoiding false-positive diagnoses and potential unnecessary surgical intervention.<\/jats:p>","DOI":"10.1007\/s00256-026-05191-6","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T20:27:49Z","timestamp":1773520069000},"page":"1681-1684","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intra-articular gas on knee MRI: a meniscal tear mimic and description of a novel MRI sign"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6989-9577","authenticated-orcid":false,"given":"Thomas","family":"Saliba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Malghem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3251-3666","authenticated-orcid":false,"given":"Patrick","family":"Omoumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,14]]},"reference":[{"key":"5191_CR1","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1113\/expphysiol.1988.sp003147","volume":"73","author":"L Wood","year":"1988","unstructured":"Wood L, Ferrell WR, Baxendale RH. Pressures in normal and acutely distended human knee joints and effects on quadriceps maximal voluntary contractions. Q J Exp Physiol. 1988;73:305\u201314. https:\/\/doi.org\/10.1113\/expphysiol.1988.sp003147.","journal-title":"Q J Exp Physiol"},{"key":"5191_CR2","doi-asserted-by":"publisher","first-page":"217","DOI":"10.3109\/10739689509146768","volume":"2","author":"JR Levick","year":"1995","unstructured":"Levick JR. Microvascular architecture and exchange in synovial joints. Microcirculation. 1995;2:217\u201333. https:\/\/doi.org\/10.3109\/10739689509146768.","journal-title":"Microcirculation"},{"key":"5191_CR3","first-page":"733","volume":"139","author":"W Magnusson","year":"1937","unstructured":"Magnusson W. \u00dcber Die Bedingungen Des Hervortretens Der Wirklichen Gelenkspalte Auf Dem R\u00f6ntgenbilde. 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