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

1. Which is the MAIN pathologic finding shown by this ultrasound picture in a patient with psoriatic arthritis?

A) Flexor tendon rupture with reparative hyperemia
B) Proximal interphalangeal osteophytes
C) Flexor tenosynovitis
D) Proximal interphalangeal synovitis

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) The needle can touch the uncovered probe during the procedure as long as sterile gel is used.
C) 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.
D) Not using probe covers during ultrasound-guided arthrocentesis has been demonstrated to lead to increased rates of joint infections.

3. Which of the following protocols would be MOST consistent with a complete routine ultrasound examination of the shoulder?

A) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oDynamic lateral long-axis assessment of impingement with abduction of the arm oPosterior transverse view of the suprascapular notch oView from cranial at the acromioclavicular joint
B) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLateral views of the subscapularis tendon
oLateral long- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior view of the glenohumeral joint recess oDynamic lateral long-axis assessment of impingement with abduction of the arm
C) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the subscapularis tendon in external rotation
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterolateral view of the infraspinatus tendon oPosterior view of the glenohumeral joint recess oView from cranial at the acromioclavicular joint
D) Anterior long- and short-axis views of the biceps tendon
oAnterior views of the pectoralis tendon insertion
oAnterior view of the coracoid ligament and rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior long- and short-axis views of the infraspinatus tendon insertion oAxillary long-axis view with arm raised

4. Which of the following is MOST likely to cause vertical lines on every image obtained from a piece of ultrasound equipment?

A) Damage to the transducer cable
B) Cracks in the transducer that may indicate breakage of piezoelectric crystal elements
C) Misaligned time-gain compensation
D) Increased number of air bubbles in the transducer gel that may impede sound waves

5. What is the MOST appropriate conclusion for the image of this hip?

A) Hip effusion in longitudinal view
B) Normal longitudinal view of the hip
C) Hip synovitis in longitudinal view
D) Iliopsoas bursitis in longitudinal view

Solutions: