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

1. An 81-year-old male with known shoulder osteoarthritis presents to the office for an ultrasound-guided injection of the glenohumeral joint. Prior to injection, where should the needle tip be visualized?

A) C
B) D
C) A
D) B

2. Which of the following statements regarding ultrasound probe care is MOST accurate?

A) External probes, when used without a cover for ultrasound-guided injections or aspiration, are considered semi-critical devices and require low-level disinfection after each use.
B) External probes that come into contact with intact skin are considered noncritical devices and require cleaning with low-level disinfectants after each use.
C) Internal-use probes are considered semi-critical devices and require low-level disinfection after each use.
D) Internal-use probes are considered critical devices and require sterilization after each use.

3. What is the BEST assessment of these longitudinal images of the pes anserinus region?

A) Tenosynovitis
B) Presence of enthesopathy with hyperemia
C) Reverberation artifact
D) Normal medial genicular artery signal

4. A 80-year-old man presents with two weeks of wrist swelling and pain. His exam reveals swelling and tenderness over the dorsum of his right wrist as well as synovial swelling of the second and third metacarpophalangeal joints of his left hand. His serum uric acid concentration is 6.0 mg/dL. The longitudinal and transverse images of the dorsal aspect of his right wrist are shown below. What is the MOST likely diagnosis?

A) Gout
B) Calcium pyrophosphate arthritis
C) Rheumatoid arthritis
D) Psoriatic arthritis

5. Which of the following structures for injection has the BEST evidence for the superiority of ultrasound guidance over palpation alone?

A) Flexor digitorum tendon at the A1 pulley
B) Subacromial bursa
C) Glenohumeral joint
D) Trochanteric bursa

Solutions: