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

1. Which situation represents the MOST appropriate indication for a practitioner to perform a musculoskeletal ultrasound in clinical practice?

A) Preoperative evaluation of a patient with suspected rotator cuff tear
B) Assessment of asymptomatic entheses in a patient with pain at the acromioclavicular joint
C) Assessment of pain and swelling of unclear etiology at the right temporomandibular joint
D) Evaluation of shoulder pain in a patient with diabetes most likely related to adhesive capsulitis

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

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

3. A practitioner wants to assess the structure marked with an asterisk (*).

What maneuver should the practitioner instruct the patient to perform of the examined joint?

A) Internal rotation and adduction
B) Lateral abduction
C) External rotation
D) Neutral position

4. 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) Both the radiocarpal and midcarpal recesses should be targeted.
B) The radiocarpal recess should be the primary target.
C) The fourth compartment ten synovium should be targeted.
D) The midcarpal recess should be the primary target.

5. To improve visualization of the hip joint of an obese patient, it would be BEST to change to a probe with which of the following?

A) Smaller footprint
B) Curvilinear structure
C) Standoff pad
D) Higher frequency

Solutions: