Sports medicine is one of the most rapidly growing subspecialties in orthopaedics and therefore radiologists will be confronted with it more and more often. With the increased use of MR imaging in evaluating joint and muscle pathology in athletes new challenges emerge. One of these challenges is the role of BME, high-signal intensity on T2-weighted MR images. Some studies find a positive association between BME and clinical complaints, whereas other studies do not. Even more interesting is the finding that BME seems to appear quite often in asymptomatic athletes, although little has been reported in the literature about the MR imaging findings in the asymptomatic knee of the dedicated athlete. As the field of sports medicine expands, radiologists will increasingly deal with the presence of BME in athletes.