In this article, the authors illustrate the contributions of incidental magnetization transfer contrast (MTC) to the signal characteristics of patellar cartilage on routine, multiplanar fast spin-echo (FSE) images. Incidental MTC diminishes the signal of patellar cartilage by 30% on routine FSE scans. Spectral fat saturation does not significantly increase incidental MTC on multislice FSE acquisitions. By increasing the contrast between synovial fluid and patellar cartilage, incidental MTC may account for greater conspicuousness of chondromalacia on FSE as compared to conventional spin-echo images. Incidental MTC may also alter or obscure the normal, laminar appearance of hyaline cartilage on short-TE, FSE images.