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

1. What should be taken into consideration prior to any procedure?

A) A slight to-and-fro movement or injection of a small amount of lidocaine may be beneficial in visualizing the needle.
B) The shortest pathway to the region of interest should be selected with consideration given to adjacent neurovascular structures.
C) The transducer should be aligned perpendicular to the plane of the needle.
D) The needle should be visualized only prior to its insertion to the target area.

2. This is a short-axis scan of the supraspinatus tendon in a normal person. What is the finding marked with the arrow?

A) Calcification of the supraspinatus tendon
B) Normal deltoid muscle
C) A probe-generated artifact
D) Subacromial bursa calcification

3. Which of the following statements is CORRECT with regard to the use of ultrasound equipment for children?" followed by four answer choices:

A) Special "hockey stick" transducers are essential to adequately image pediatric joints
B) Ultrasonography has limitations in imaging the relatively small structures in pediatric joints
C) Pediatric joints can be imaged with the same ultrasound equipment used for adults
D) High-Trequency probes are necessary to adapt to the small pediatric joints

4. 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 hyperechoic intra-articular tissue with Doppler signal
C) Abnormal hyperechoic extra-articular tissue with Doppler signal
D) Abnormal hypoechoic extra-articular tissue with Doppler signal

5. At approximately how many degrees of flexion is the MOST sensitive resting position of the knee for imaging fluid in the suprapatellar recess?

A) 30
B) 15
C) 0
D) 45

Solutions: