Hi Paul,
I agree completely with you,
What you have here is an inappropriate referral.
Here in Australia we go so far that if a referral says “?meniscal tear” or “?cruciate injury” the government Medicare system will refuse to pay for it.
Ultrasound should not be used as a primary investigation of these pathologies.
Following up a proven MRI lesion with ultrasound is a complete waste of time.
There are occasions when I am asked to assess for example the MCL and I notice a medial meniscus is extruded, a bit patchy in texture and there may be a para meniscal cyst. In this case I would report that there is a high likelihood of a meniscal tear and recommend MRI assessment if clinically appropriate.
The role of ultrasound in the knee is fairly limited and certainly for meniscal tears it is not an appropriate test.
Steve