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

1. A 80-year-old man presents with two weeks of wrist swelling and pain. His exam reveals swelling and tenderness over the dorsum of his right wrist as well as synovial swelling of the second and third metacarpophalangeal joints of his left hand. His serum uric acid concentration is 6.0 mg/dL. The longitudinal and transverse images of the dorsal aspect of his right wrist are shown below. What is the MOST likely diagnosis?

A) Calcium pyrophosphate arthritis
B) Psoriatic arthritis
C) Rheumatoid arthritis
D) Gout

2. Which statement is TRUE regarding the techniques that can minimize infection during ultrasound-guided procedures?

A) Povidone iodine swab of the injection site has been demonstrated to be insufficient to minimize infection during ultrasound-guided arthrocentesis.
B) Not using probe covers during ultrasound-guided arthrocentesis has been demonstrated to lead to increased rates of joint infections.
C) The needle can touch the uncovered probe during the procedure as long as sterile gel is used.
D) Sterile probe covers with sterile coupling gel can be employed during intra-articular injections, particularly those that require close proximity between the transducer and the needle tip.

3. What is the MAXIMUM normal distance between the markers in this plantar longitudinal view of the foot?

A) 9.3 mm
B) 7.3 mm
C) 5.3 mm
D) 3.3 mm

4. What is the BEST description for this longitudinal ultrasound scan of a 75-year-old patient with pain in the medial aspect of the knee?

A) Osteophytes and distension and calcification of the medial collateral ligament
B) Osteophytes and rupture of the medial collateral ligament
C) Osteophytes, distension of the medial collateral ligament, and meniscal degeneration
D) Osteophytes and meniscal cyst

5. Which of these supraspinatus longitudinal images has the BEST combination of ultrasound machine settings?

A) Option A
B) Option B
C) Option C
D) Option D

Solutions: