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

1. To determine whether the hypoechogenic region results in true pathology or artifact, which of the following maneuvers would OPTIMIZE the ultrasound assessment of the quadriceps tendon depicted in the image shown?

A) Tissue compression at the distal transducer edge
B) Rotation of the distal transducer edge
C) Quadriceps contraction
D) Passive knee extension

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

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

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

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

5. 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) A metacarpal fragment from prior trauma
D) The tip of an osteophyte

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