A 13-year-old boy with chronic right knee pain underwent MR imaging evaluation. The study revealed a cord-like structure (Fig. 1, arrow) originating from the anterior horn of the medial meniscus and coursing through the intercondylar notch and inserting on the posterior horn of the lateral meniscus. On a sagittal image, there was a linear fibrous band lying inferior to the posterior cruciate ligament (Fig. 2, arrow) simulating the double posterior cruciate ligament sign seen with bucket-handle meniscal tears. This linear structure represents a medial oblique meniscomeniscal ligament. No abnormality was identified to account for the child’s pain.

Fig. 1
figure 1

Axial T2-weighted image

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Fig. 2
figure 2

Sagittal intermediate-weighted image

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The four ligaments that connect the medial and lateral menisci are: the anterior transverse meniscal ligament (58% incidence), the posterior transverse meniscal ligament (1–4%), and two oblique meniscomeniscal ligaments, medial and lateral, named by their anterior attachments (1–4%) [1]. The oblique meniscomeniscal ligament should not be mistaken for a displaced meniscal fragment from a flap or bucket-handle tear [2].