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

1. A 30-year-old female patient with rheumatoid arthritis reports pain at the medial malleolus. The medial side of the ankle is tender and seems to be swollen. How should a practitioner interpret the transverse images at the medial malleolus?

A) Tenosynovitis of the flexor hallucis longus
B) Tenosynovitis of the flexor digitorum
C) Tenosynovitis of the tibialis anterior tendon
D) Neurom of the tibiatis posterior nerve

2. Ultrasound is the MOST appropriate tool to evaluate which of these structures for pathology?

A) Cartilage loss quantification in a patient with osteoarthritis
B) Achilles tendon insertion site in a patient with spondyloarthropathy, assessing for enthesopathy
C) Sacroiliac joint in a patient with positive HLA B27 and inflammatory-type lower back pain, assessing for joint space narrowing
D) Temporomandibular joint in a patient with juvenile idiopathic arthritis, assessing for erosions

3. 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) Not using probe covers during ultrasound-guided arthrocentesis has been demonstrated to lead to increased rates of joint infections.
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.

4. Proper maintenance of ultrasound equipment between use for each patient is important to prevent which of the following?

A) Examiner injury
B) Poor calibration
C) Radiation exposure
D) Infection

5. 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) Subacromial bursa calcification
C) Normal deltoid muscle
D) A probe-generated artifact

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