American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology

QUESTION NO: 1
A 37-year-old female with a history of rheumatoid arthritis presents for sonographic evaluation. She has been in clinical remission for six months and is considering discontinuation of her biologic agent. Sonography of the right third metacarpophalangeal joint is shown. Which of the following is the MOST accurate description regarding this image?

A. Abnormal hypoechoic intra-articular tissue with Doppler signal B. Abnormal hypoechoic extra-articular tissue with Doppler signal C. Abnormal hyperechoic extra-articular tissue with Doppler signal D. Abnormal hyperechoic intra-articular tissue with Doppler signal

Correct Answer: A

QUESTION NO: 2
In imaging the volar wrist in transverse, this Doppler view helps confirm the presence of which of the following?

A. Persistent median artery B. Median nerve impingement C. Anomalous radial artery D. Flexor tenosynovitis

Correct Answer: A

QUESTION NO: 3
Which of the dorsal longitudinal metacarpophalangeal images below MOST suggests the diagnosis of rheumatoid arthritis?

A. A close-up of a ultrasound Description automatically generated B. An ultrasound image of a human body Description automatically generated

C. A close-up of an ultrasound Description automatically generated

D. A close-up of a black and white image Description automatically generated

Correct Answer: B

QUESTION NO: 4
An 81-year-old male with known shoulder osteoarthritis presents to the office for an ultrasound-guided injection of the glenohumeral joint. Prior to injection, where should the needle tip be visualized?

A. D B. B C. C D. A

Correct Answer: A

QUESTION NO: 5
For which of the following conditions is the use of diagnostic musculoskeletal ultrasound appropriate?

A. Tibial stress fracture B. Meniscal tear C. Osgood-Schlatter disease D. Anterior cruciate ligament tear

Correct Answer: C

QUESTION NO: 6
For which of the following clinical scenarios is it appropriate for a practitioner to perform musculoskeletal ultrasound?

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

Correct Answer: C

QUESTION NO: 7
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.

Correct Answer: D

QUESTION NO: 8
Gray-scale and Doppler ultrasound evaluation examination alone would BEST assist in establishing a diagnosis in which of the following scenarios?

A. Warm, swollen elbow joint in a 70-year-old lymphoma patient with fevers and a history of an abscess of the thoracic spine B. 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 C. Sacroiliac joints in a 35-year-old male with early morning low-back pain and positive HLA B27 D. 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

Correct Answer: C

QUESTION NO: 9
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. A normal sesamoid C. The tip of an osteophyte D. A metacarpal fragment from prior trauma

Correct Answer: B

QUESTION NO: 10
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 fourth compartment ten synovium should be targeted. B. The radiocarpal recess should be the primary target. C. The midcarpal recess should be the primary target. D. Both the radiocarpal and midcarpal recesses should be targeted.

Correct Answer: D

American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology - RhMSUS Exam Questions