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

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

2. What is the MOST prominent ultrasound artifact depicted in this image?

A) Ring down
B) Shadowing
C) Enhancement
D) Comet tail

3. For which of the following clinical scenarios is it appropriate for a practitioner to perform musculoskeletal ultrasound?

A) A patient with psoriasis and posterior heel pain
B) A 40-year-old man with a snapping sensation in his groin with hip flexion and external rotation
C) A patient who has pain and numbness over the lateral calf
D) A 50-year-old woman with pain between the third and fourth metatarsals

4. The change between the ankle depicted in the first and second images would BEST be explained by which of the following?

A) Increased gain
B) Decreased synovitis
C) Decreased transducer pressure
D) Decreased frequency

5. Ultrasound is the MOST appropriate tool to evaluate which of these structures for pathology?

A) Cartilage loss quantification in a patient with osteoarthritis
B) Achilles tendon insertion site in a patient with spondyloarthropathy, assessing for enthesopathy
C) Sacroiliac joint in a patient with positive HLA B27 and inflammatory-type lower back pain, assessing for joint space narrowing
D) Temporomandibular joint in a patient with juvenile idiopathic arthritis, assessing for erosions

Solutions: