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American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology Sample Questions:

1. A practitioner reviews this long-axis ultrasound image of the medial aspect of the knee. Which of the following is the MOST likely differential diagnosis?

A) Topheaceous gout with displacement of the medial collateral ligament
B) Rheumatoid arthritis with erosion formation
C) No sonographic evidence for abnormality
D) Osteoarthritis with bone spur and extrusion of the medial meniscus

2. Which effect is achieved by increasing the gain while in Doppler mode?

A) Reduced noise artifacts in the image
B) Increased image brightness
C) Increased sensitivity to flow
D) Increased tissue penetration

3. A patient with diabetes presents with right ankle pain and swelling. The practitioner is unsure of the cause and decides to perform a musculoskeletal ultrasound examination. Which of the following in the practitioner's report is the BEST statement of indication for this study?

A) Inflammatory arthritis
B) Ruling out of infection
C) Ruling out of inflammatory arthritis
D) Ankle pain

4. A woman with a history of long-standing rheumatoid arthritis presents with persistent, chronic wrist pain and swelling. What do the patient's ultrasound images demonstrate?

A) Ganglion cyst rupture
B) Extensor tenosynovitis
C) Rheumatoid nodulosis
D) Extensor tendon tear

5. What should be taken into consideration prior to any procedure?

A) A slight to-and-fro movement or injection of a small amount of lidocaine may be beneficial in visualizing the needle.
B) The transducer should be aligned perpendicular to the plane of the needle.
C) The shortest pathway to the region of interest should be selected with consideration given to adjacent neurovascular structures.
D) The needle should be visualized only prior to its insertion to the target area.

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