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Three stripes sign: muscle involvement with internal fibrosis in a patient with sarcoidosis

A 62-year-old previously healthy woman was referred to the orthopaedic department because of bilateral thigh pain accompanied by palpable subcutaneous nodules in both thighs. The extremity coronal MRI with fat-suppressed T2-weighted images showed an inner stripe of decreased signal intensity with outer stripes of increased signal intensity, the so-called three stripes sign, both in the left vastus lateralis (figure 1A, arrow) and bilateral vastus medialis muscles (figure 1A, arrowheads), while, on axial image, decreased signal intensity, a ‘dark star’ sign was seen both in the left vastus lateralis (figure 1B, arrow) and bilateral vastus medialis muscles (figure 1B, …