Figure 1
Plain radiograph.
O'Donoghue's unhappy triad
SectionMusculoskeletal system
Case TypeClinical Cases
AuthorsJ. Davis, V.C. Pullicino
Connected authors
29 years, male
Clinical History
The patient injured his knee playing football. A plain film was unremarkable so he underwent an MRI examination.
Imaging Findings
The patient injured himself during a tackle playing football. At the time of the injury he heard a 'pop' from his knee. A plain radiograph demonstrated a joint effusion but no lipohaemarthrosis or fracture. He was treated conservatively but did not improve so was referred for an MRI of the knee. The MRI demonstrated soft tissue damage to the medial collateral ligament, anterior cruciate ligament and lateral meniscus. This constitutes the O'Donoghue's triad. Bone bruising to the lateral femoral condyle and tibial plateau is also shown.
Discussion
O'Donoghue in 1950 described a triad of a tear in the anterior cruciate ligament and disruption of the medial collateral ligament associated with a medial meniscal tear. More recent studies using arthroscopic examination of patients have shown that the triad as described by O'Donoghue is an unusual clinical entity among knee injuries. It is far more common for a lateral meniscal tear to be associated with combined medial collateral and anterior cruciate ligament injuries. If a medial meniscal tear is present then there is an associated lateral meniscal tear. The term O'Donoghue's triad is therefore used by orthopaedic radiologists to denote a meniscal tear associated with an anterior cruciate and medial collateral ligament injury.
Differential Diagnosis List
O'Donoghue's triad
Final Diagnosis
O'Donoghue's triad
Case information
| URL: | https://eurorad.org/case/2045 |
| DOI: | 10.1594/EURORAD/CASE.2045 |
| ISSN: | 1563-4086 |
Figure 2
MRI of the knee
Coronal T1-weighted image. There is disruption of the medial collateral ligament.
Coronal STIR image. Marked oedema is seen around the disrupted medial collateral ligament. There is a bone bruise in the lateral femoral condyle and oedema around the lateral collateral ligament.
Coronal T1-weighted image. There is a bucket handle tear of the lateral meniscus with the medial fragment seen in the intercondylar notch.
Coronal STIR image. There is a bucket handle tear of the lateral meniscus. There is a bone bruise in the lateral tibial plateau.
Sagittal T1-weighted image. There is disruption of the anterior cruciate ligament.
Sagittal STIR image. There is disruption of the anterior cruciate ligament and a joint effusion.
MRI of the knee
Coronal T1-weighted image. There is disruption of the medial collateral ligament.
Coronal STIR image. Marked oedema is seen around the disrupted medial collateral ligament. There is a bone bruise in the lateral femoral condyle and oedema around the lateral collateral ligament.
Coronal T1-weighted image. There is a bucket handle tear of the lateral meniscus with the medial fragment seen in the intercondylar notch.
Coronal STIR image. There is a bucket handle tear of the lateral meniscus. There is a bone bruise in the lateral tibial plateau.
Sagittal T1-weighted image. There is disruption of the anterior cruciate ligament.
Sagittal STIR image. There is disruption of the anterior cruciate ligament and a joint effusion.