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

1. The image below shows the injection of the dorsal wrist region in a patient with rheumatoid arthritis. The needle is indicated by the arrows. Considering the ultrasound findings, which of the following is MOST appropriate in completing the injection?

A) The midcarpal recess should be the primary target.
B) The radiocarpal recess should be the primary target.
C) The fourth compartment ten synovium should be targeted.
D) Both the radiocarpal and midcarpal recesses should be targeted.

2. What is the appropriate image documentation for an ultrasound study evaluating sonographic synovitis in bilateral hand and wrist joints in a patient with rheumatoid arthritis?

A) Images of the sonographic views with the presence of power Doppler and/or gray-scale synovitis only
B) Representative sonographic image example of power Doppler and gray-scale synovitis supplemented by a detailed report of each examined joint
C) Images of the sonographic views with the presence of power Doppler synovitis only
D) All appropriate sonographic views of every joint examined

3. A practitioner obtains this image of a metacarpophalangeal joint of a patient with periodic joint swelling and warmth. Which of the following is the MOST likely diagnosis?

A) Gouty arthritis
B) Rheumatoid arthritis
C) Spondylarthritis
D) Osteoarthritis

4. The best way to facilitate visualization of ultrasound images in an exam room.

A) Brighten the ambient lighting to improve the signal-to-noise ratio
B) Decrease the amount of gel in between transducer and skin to improve transmission of sound waves
C) Decrease high-frequency ambient noise to minimize interfering sound waves
D) Dim the exam room lighting to improve the signal-to-noise ratio (This is the best answer)

5. What is the MOST appropriate conclusion for the image of this hip?

A) Iliopsoas bursitis in longitudinal view
B) Hip synovitis in longitudinal view
C) Hip effusion in longitudinal view
D) Normal longitudinal view of the hip

Solutions: