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

1. A 30-year-old pregnant woman with rheumatoid arthritis presents with right wrist pain and swelling despite a palpation-guided corticosteroid injection one month ago.

A) Intercarpal joint
B) Radioulnar joint
C) Extensor tenosynovium
D) Radiocarpal joint

2. How reliable is ultrasound as compared to other imaging modalities for diagnosing synovitis in the joints of the fingers?

A) Ultrasound is inferior to MRI and X-ray in sensitivity.
B) Ultrasound is inferior to MRI but superior to clinical exam in sensitivity.
C) Ultrasound is as sensitive as MRI but superior to X-ray.
D) Ultrasound is inferior to MRI but superior to X-ray in sensitivity.

3. A 78-year-old woman presents with three days of ankle pain and swelling. Her exam reveals swelling localized around the medial malleolus, and any motion or palpation causes pain. The medial transverse ultrasound view of the ankle is shown. Based on her presentation and the ultrasound image, what is the MOST likely anatomic structure from which her pain is emanating?

A) Flexor hallucis
B) Flexor digitorum
C) Subtalar joint
D) Posterior tibial tendon

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

5. This is a short-axis scan of the supraspinatus tendon in a normal person. What is the finding marked with the arrow?

A) A probe-generated artifact
B) Normal deltoid muscle
C) Subacromial bursa calcification
D) Calcification of the supraspinatus tendon

Solutions: