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

1. The second finger was examined. Which of the following is shown in the image below?

A) Proximal interphalangeal, palmar longitudinal view
B) Proximal interphalangeal, dorsal longitudinal view
C) Metacarpophalangeal, palmar longitudinal view
D) Metacarpophalangeal, dorsal longitudinal view

2. Which of the following is required in a report documenting an ultrasound-guided procedure?

A) Image labeled with exam date, patient identification, image orientation, and image views of the target area
B) Section detailing ultrasonographic observations of any variations from the normal accompanied by measurements
C) Image showing needle in the target structure or orthogonal images of the target structure before and after injection
D) Sections detailing medical indication for procedure, study type (limited versus complete), and overall clinical impressions

3. 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 tibialis anterior tendon
C) Tenosynovitis of the flexor digitorum
D) Neurom of the tibiatis posterior nerve

4. Which of these supraspinatus longitudinal images has the BEST combination of ultrasound machine settings?

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

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

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