"Unhappy Triad" Lateral or Medial Meniscus Injury! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 04-23-2010
doctorF's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 316
Threads: 68
Thanked 408 Times in 110 Posts
Reputation: 428
Rheumatology/Orthopedics "Unhappy Triad" Lateral or Medial Meniscus Injury!

guys i have a query....

About "unhappy triad"

Goljan's RR says:

It consists of damage to medial leminiscus, anterior cruciate and medial meniscus (pg536)

Whereas FA says::

It's a common football injury consists of damage to medial leminiscus, anterior cruciate and lateral (not medial) meniscus (pg 366)
__________________
Why does Good luck often carries more weightage than hard work in successes???
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulhakeem (05-19-2011), ath.pantelis (04-23-2010), aungawa (04-24-2010), CHAKRAM (12-16-2011), drnyinyithan (04-24-2010), Taiwan_Guy (05-19-2011)



  #2  
Old 04-23-2010
Ex-USMLE Forums Staff
 
Steps History: 1+CK+CS+3
Posts: 753
Threads: 106
Thanked 2,196 Times in 465 Posts
Reputation: 2244
Arrow It's the lateral meniscus

Initially it was thought to be the medial meniscus. But in 1991 the triad has been redefined to the Lateral Meniscus

Ref:
http://ajs.sagepub.com/content/19/5/474
Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulhakeem (05-19-2011), ath.pantelis (04-23-2010), doctorF (04-24-2010), INCOGNITO (05-17-2012), Seetal (04-23-2010), Taiwan_Guy (05-19-2011), Thrax_usmle (05-04-2012)
  #3  
Old 04-24-2010
USMLE Forums Newbie
 
Steps History: 1 + CS
Posts: 2
Threads: 0
Thanked 25 Times in 2 Posts
Reputation: 35
Smile reply to un happy triad conflict

UNhappy triad injury to the knee happens in soccer game, when the person got kicked from the lateral side of the knee...this will cause opening or stretching of the structures on the medial side of the knee...namely Medial longitudinal ligament, medial meniscus and anterior cruciate ligament....and these 3 structures are damaged and hence called TRIAD........THAT was the original theory....BUT later in 1990's, they did the research and studies of sports knee injury, which showed, LATERAL meniscus was also injured in those injury....and was stated as 56% for lateral meniscus and 44% for medial meniscus......I hope this answer your question..
Reply With Quote Quick reply to this message
The above post was thanked by:
Abdulhakeem (05-19-2011), AMIODARONE (12-15-2011), astrocarter15 (01-22-2015), Awwad (05-03-2013), belindalimm (10-12-2011), busterbee (09-04-2011), cadaver (05-19-2011), cerebrum85 (09-10-2011), doctorF (04-24-2010), Hamada (06-15-2014), INCOGNITO (05-17-2012), Learner (12-25-2011), magzoub (10-06-2010), Mashee (06-22-2011), prataptetali (05-19-2011), rasheed (04-24-2010), Saiyeda (07-27-2011), Sana Zahid (07-19-2011), star123 (05-22-2011), Taiwan_Guy (05-19-2011), Thrax_usmle (05-04-2012), zohra (11-19-2011)
 
  #4  
Old 07-26-2011
USMLE Forums Addict
 
Steps History: Not yet
Posts: 151
Threads: 39
Thanked 52 Times in 29 Posts
Reputation: 62
Angry Its medial???

Quote:
Originally Posted by lee-usmle View Post
Initially it was thought to be the medial meniscus. But in 1991 the triad has been redefined to the Lateral Meniscus

Ref:
http://ajs.sagepub.com/content/19/5/474
Well, I have checked Campbell orthopedics which considered to be the Bible of orthopedics. Even it says Medial Meniscus
Reply With Quote Quick reply to this message
The above post was thanked by:
MiSeRy (03-12-2014)
  #5  
Old 07-26-2011
dr.Irina's Avatar
USMLE Forums Veteran
 
Steps History: 1 + CK
Posts: 229
Threads: 6
Thanked 73 Times in 62 Posts
Reputation: 83
Default

The "classic unhappy triad" (O’Donoghue’s triad) due to an acute valgus stress on the knee involves the ACL, MCL, and medial meniscus.
However, recent studies suggest two things:
1. The triad of ACL, MCL and lateral meniscus injury is actually more common than the classic triad following acute valgus stress on the knee
2. In patients that do develop the classic unhappy triad , only the ACL and MCL are acutely injured during the acute valgus stress on the knee, while the injury to the medial meniscus is the result of chronic injury secondary to ACL insufficiency
Reply With Quote Quick reply to this message
The above post was thanked by:
cerebrum85 (09-10-2011)
  #6  
Old 08-18-2011
whocares13's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 145
Threads: 8
Thanked 76 Times in 57 Posts
Reputation: 86
Correct Answer Unhappy Triad

Getting confused.

Unhappy Triad is:
1) injury to ACL
2) injury to MCL
3) injury to Medial meniscus or Lateral meniscus??

Kaplan says Medial and FA says Lateral(not medial) on page 366.

Can anyone explain??

Thank you.

EDIT: I read this thread and I think FA is correct and it is Lateral Meniscus and not Medial Meniscus.

Also confirmed from wikipedia.

Ref: Unhappy Triad

Ref: Wikipedia

Last edited by whocares13; 08-18-2011 at 04:22 PM.
Reply With Quote Quick reply to this message
  #7  
Old 08-18-2011
USMLE Forums Addict
 
Steps History: Not yet
Posts: 144
Threads: 34
Thanked 33 Times in 24 Posts
Reputation: 43
Default Medial Meniscus

First Aid some errors now and then. Its medial Meniscus!

Quote:
Originally Posted by whocares13 View Post
Getting confused.

Unhappy Triad is:
1) injury to ACL
2) injury to MCL
3) injury to Medial meniscus or Lateral meniscus??

Kaplan says Medial and FA says Lateral(not medial) on page 366.

Can anyone explain??

Thank you.
Reply With Quote Quick reply to this message
The above post was thanked by:
whocares13 (08-18-2011)
  #8  
Old 08-18-2011
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 69
Threads: 4
Thanked 76 Times in 21 Posts
Default

It's medial meniscus
Campbell's Operative Orthopaedics, 11th ed.
Chapter 43 – Knee Injuries
Reply With Quote Quick reply to this message
The above post was thanked by:
whocares13 (08-18-2011)
  #9  
Old 08-18-2011
whocares13's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 145
Threads: 8
Thanked 76 Times in 57 Posts
Reputation: 86
Correct Answer

I read this thread and I think FA is correct and it is Lateral Meniscus and not Medial Meniscus.

Also confirmed from wikipedia.

Ref: Unhappy Triad

Ref: Wikipedia
Reply With Quote Quick reply to this message
  #10  
Old 08-18-2011
drnirajmavani's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 268
Threads: 14
Thanked 103 Times in 69 Posts
Reputation: 113
Default

Unhappy triad occurs when u get a blow on ur knee frm the lateral side....so its the the LATERAL meniscus thats going to crush between the femur and tibia...
Reply With Quote Quick reply to this message
  #11  
Old 08-18-2011
Hope2Pass's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,684
Threads: 213
Thanked 1,600 Times in 660 Posts
Reputation: 1610
Default

Read these answers by some members on a different post -->

Quote:
Originally Posted by lee-usmle View Post
Initially it was thought to be the medial meniscus. But in 1991 the triad has been redefined to the Lateral Meniscus

Ref:
http://ajs.sagepub.com/content/19/5/474
Quote:
Originally Posted by drnyinyithan View Post
UNhappy triad injury to the knee happens in soccer game, when the person got kicked from the lateral side of the knee...this will cause opening or stretching of the structures on the medial side of the knee...namely Medial longitudinal ligament, medial meniscus and anterior cruciate ligament....and these 3 structures are damaged and hence called TRIAD........THAT was the original theory....BUT later in 1990's, they did the research and studies of sports knee injury, which showed, LATERAL meniscus was also injured in those injury....and was stated as 56% for lateral meniscus and 44% for medial meniscus......I hope this answer your question..

Look here, they have a good discussion - http://www.usmle-forums.com/usmle-st...us-injury.html
Reply With Quote Quick reply to this message
  #12  
Old 08-18-2011
USMLE Forums Addict
 
Steps History: ---
Posts: 191
Threads: 69
Thanked 150 Times in 75 Posts
Reputation: 160
Default confused

i searced for it and yes it's right that recently they found injury to lateral menscus more common but in many books like kaplan and others still sticking to the medial menscus so if it comes in exam which one should be chossen ???????
Reply With Quote Quick reply to this message
  #13  
Old 08-18-2011
whocares13's Avatar
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 145
Threads: 8
Thanked 76 Times in 57 Posts
Reputation: 86
Default

Quote:
Originally Posted by menatallah Elgohary View Post
i searced for it and yes it's right that recently they found injury to lateral menscus more common but in many books like kaplan and others still sticking to the medial menscus so if it comes in exam which one should be chossen ???????
Lateral meniscus as FA have written with bold letters NOT MEDIAL
Reply With Quote Quick reply to this message
The above post was thanked by:
menatallah Elgohary (08-19-2011)
  #14  
Old 08-18-2011
dr pinky's Avatar
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 38
Threads: 4
Thanked 10 Times in 9 Posts
Default

If injury is acute then it's Lateral meniscus
If injury is Chronic then it's Medial meniscus
Reply With Quote Quick reply to this message
The above post was thanked by:
drortho (11-29-2011), menatallah Elgohary (08-19-2011)
  #15  
Old 11-19-2011
USMLE-Syndrome's Avatar
USMLE Forums Master
 
Steps History: ---
Posts: 1,203
Threads: 180
Thanked 1,254 Times in 441 Posts
Reputation: 1268
Default unhappy triad knee injury (1st aid& kaplan )

unhappy triad knee injury in 1st aid page 366
(ACL & lateral meniscus and MCL)
while in kaplan anatomy page 300 is (ACL & MCL& medial menscus )

which one is right

???????????????????????????
Reply With Quote Quick reply to this message



  #16  
Old 11-19-2011
dr.muhamad's Avatar
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 300
Threads: 22
Thanked 97 Times in 62 Posts
Reputation: 107
Default

Quote:
Originally Posted by miss patho View Post
unhappy triad knee injury in 1st aid page 366
(ACL & lateral meniscus and MCL)
while in kaplan anatomy page 300 is (ACL & MCL& medial menscus )

which one is right

???????????????????????????
okay let me tell u sth i searched about this thing alot
and finally i came up with this; they r both right and it is like 60% lateral meniscus and 40 % medial
so the best to answer is lateral but if u find one answer saying medial then choose it
Reply With Quote Quick reply to this message
The above post was thanked by:
aknz (12-15-2011), AMIODARONE (12-15-2011), USMLE-Syndrome (11-19-2011)
  #17  
Old 11-19-2011
shyangel18's Avatar
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 388
Threads: 48
Thanked 237 Times in 128 Posts
Reputation: 247
Send a message via MSN to shyangel18
Default

according to UWORLD.. its Medial meniscus medial collateral lig and ant cruciate ligament!
so if i were to chose bw the two.. medial or lateral meniscus.. id go with UW!!
note i jus did that question a couple of days ago! so m 100% sure!!
__________________
Ppl come here to study n ponder
I am here to Excell like Thunder!
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
drortho (11-29-2011), USMLE-Syndrome (11-19-2011), USMLE2011m (11-19-2011)
  #18  
Old 12-15-2011
rapiddo's Avatar
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 70
Threads: 12
Thanked 51 Times in 21 Posts
Reputation: 61
Default Unhappy Knee Triad

I'm seeing conflicting ideas about the unhappy knee triad :
Kaplan Lecture notes says: Medial Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament while
First Aid 2011 says: Lateral Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament.
Please, need clarification.
Thanks.
Reply With Quote Quick reply to this message
  #19  
Old 12-15-2011
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 44
Threads: 4
Thanked 5 Times in 5 Posts
Reputation: 15
Default

Quote:
Originally Posted by rapiddo View Post
I'm seeing conflicting ideas about the unhappy knee triad :
Kaplan Lecture notes says: Medial Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament while
First Aid 2011 says: Lateral Meniscus, Medial Collateral Ligament and Anterior Cruciate Ligament.
Please, need clarification.
Thanks.
From doing questions the correct answer is LM,MCL and ACL. I guess the lateral meniscus is the most common. I found this article, hopefully it will help.
http://ajs.sagepub.com/content/19/5/474
Reply With Quote Quick reply to this message
The above post was thanked by:
rapiddo (12-15-2011)
  #20  
Old 12-15-2011
USMLE Forums Scout
 
Steps History: Not yet
Posts: 46
Threads: 3
Thanked 34 Times in 20 Posts
Reputation: 44
Default

I do not know the story behind how O'Donoghue originally described this now classic "Unhappy Triad". But let us remember that even half a century ago doctors (and other people) often relied on pure academic reasoning without proof from clinical studies for medical decision making (think why we didn't use beta blockers in CHF). I am not saying this is what O'Donoghue did but let us think of the philosophy behind this unhappy triad.

1. Knee injuries are common.

2. Common sporting knee injuries involve a lateral stress applied to the knee (e.g. a side tackle). This usually involves an anterior component as well as the tackler comes from behind.

3. For common things we like to have triads! (or mnemonics, or just any easy stereotype to remember things by).

4. The ACL is weak so it is torn easily. The lateral application of force exerts stress on the Medial Collateral Ligament which is actually connected to the medial meniscus. It "makes sense" that torn of both should occur together. Eureka!

I. ACL tear
II. Medial collateral ligament tear
III. Medial meniscus tear

5. Evidence-based medicine comes along and attempts to test this about a decade later. Unfortunately the triad really does not hold. Lateral meniscus tear are far more common so a re-formulation of this concept should take place. So now the triad should really be

I. ACL tear
II. MCL tear
III. Lateral meniscus tear

But really it is a variable concept. Some textbooks will tell you the classic triad, some textbooks won't tell you such a triad at all. In fact other than FA, I've never seen this triad described with a lateral meniscus tear. I presume that it means it can't be tested unless physical findings are given but I am probably wrong.
Reply With Quote Quick reply to this message
  #21  
Old 12-15-2011
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 623
Threads: 111
Thanked 424 Times in 264 Posts
Reputation: 434
Default

I listened to DIT, dr brain says :

It can be medial or lateral meniscus ,so I think in question both options will not be given together
Reply With Quote Quick reply to this message
  #22  
Old 05-17-2012
rapiddo's Avatar
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 70
Threads: 12
Thanked 51 Times in 21 Posts
Reputation: 61
Default

Here comes the Unhappy triad again:
FA caused a lot of confusion by listing lateral meniscus as a part of the triad...and now in the 2012 Errata ,it says it is medial meniscus.
So, I guess we can now all agree it's medial meniscus and not lateral meniscus.

http://firstaidteam.com/wp-content/u...a-120425v2.pdf
Reply With Quote Quick reply to this message
  #23  
Old 05-17-2012
RocketMD's Avatar
USMLE Forums Scout
 
Steps History: Step 1 Only
Posts: 50
Threads: 5
Thanked 59 Times in 23 Posts
Reputation: 69
Default

Quote:
Originally Posted by rapiddo View Post
Here comes the Unhappy triad again:
FA caused a lot of confusion by listing lateral meniscus as a part of the triad...and now in the 2012 Errata ,it says it is medial meniscus.
So, I guess we can now all agree it's medial meniscus and not lateral meniscus.

http://firstaidteam.com/wp-content/u...a-120425v2.pdf
Read the reference by Lee (second post above).
It's the lateral not the medial.
Reply With Quote Quick reply to this message



Reply

Tags
Anatomy-, Musculoskeletal-, Pathology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Dorsal Column Medial Lemniscal System Video! INCOGNITO USMLE Step 1 Forum 1 12-08-2011 10:24 PM
2 CM medial to the biceps tendon injury! earthpole USMLE Step 1 Forum 3 06-20-2011 12:18 PM
The Unhapppy Triad knee Injury dr-mak USMLE Step 1 Forum 4 05-19-2011 10:10 AM
Lateral Hip Rotators jackat1000 USMLE Step 1 Mnemonics 0 06-27-2010 06:13 PM
Lateral Medullary Vs Lateral Pontine rasheed USMLE Step 1 Bits & Pieces 0 09-18-2009 03:23 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)