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

2. Which of the following anatomic structures BEST fits the scope of rheumatologic ultrasound practice?

A) Metacarpal volar plate
B) Posterior patellar cartilage
C) Posterior cruciate ligament
D) Anterior glenoid labrum

3. A scratch along the rubber sole of a transducer is MOST likely to cause which of the following?

A) No impact on image acquisition
B) Risk of electrical shock
C) Increased risk of the spread of infection
D) Artifact in the B-Mode image

4. In this volar transverse image of the second metacarpophalangeal joint, the hyperechoic focus indicated by the arrow is which of the following?

A) A foreign body
B) The tip of an osteophyte
C) A metacarpal fragment from prior trauma
D) A normal sesamoid

5. Gray-scale and Doppler ultrasound evaluation examination alone would BEST assist in establishing a diagnosis in which of the following scenarios?

A) Knee in a 72-year-old female with unilateral knee pain, no swelling on examination, and medial narrowing of the joint space on knee radiograph
B) Sacroiliac joints in a 35-year-old male with early morning low-back pain and positive HLA B27
C) Asymptomatic hand and wrist joints with bony deformities present in a 60-year-old female with a positive rheumatoid factor and CCP antibody but normal sedimentation rate and C-reactive protein level
D) Warm, swollen elbow joint in a 70-year-old lymphoma patient with fevers and a history of an abscess of the thoracic spine

Solutions: