Diagnostic follow up Ultrasound following MRI of the knee

[Paul Stevens Whitehead]

Hi Stephen
Interesting and very informative presentation on the knee and thigh. Here In the Uk I come up against the ever common scenario where doctors refer for ultrasound after receiving diagnosis from an MRI. Recently I was given a referral for a knee ultrasound ? lateral Meniscal tear. The patient informed me that a recent MRI had confirmed the diagnosis but wanted to know if there was any Improvement. What you have said in this webinar confirms what I told her however she insisted on knowing if there is any improvement on the ultrasound. I would like your opinion on whether it is appropriate to call a meniscal tear at any time on an ultrasound alone? Even though the appearance may suggest a tear i feel that is the limit of what we can say, especially given the fact that none of our scans are reviewed by Radiologists and our reports go from our keyboards direct to the referring GP here in the UK.

Loved the webinar Hope you are well.
Kind regards Paul

[Stephen Bird]

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

[Paul Stevens Whitehead]

Thanks for clearing that up Steve.

Cheers

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