O'Donoghue unhappy triad

Case contributed by Anil Kumar Geetha Virupakshappa
Diagnosis certain


Football injury

Patient Data

Age: 20 years
Gender: Female

Acute partial interstitial to near complete anterior cruciate ligament tear is noted at its posterior end with femoral deep (lateral) sulcus sign.

Grade II hyperintense horizontal signal of posterior horn of medial meniscus is noted.

Grade I medial collateral ligament injury is noted.

Marrow edema of lateral femoral and lateral tibial condyles is noted.

These features constitute O'Donoghue unhappy triad.

Mild joint effusion is noted extending to suprapatellar bursa.

Hoffa's fat pad shows infrapatellar plical sprain.

The posterior cruciate ligament is intact. The lateral meniscus appears normal. The lateral collateral ligament appears intact. Quadriceps and patellar tendon appear intact.

Case Discussion

O'Donoghue described the injuries as anterior cruciate ligament injury, medial meniscus injury and medial collateral ligament injury, often due to abduction-external rotation mechanism of injury.

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