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

1. What is the appropriate image documentation for an ultrasound study evaluating sonographic synovitis in bilateral hand and wrist joints in a patient with rheumatoid arthritis?

A) Representative sonographic image example of power Doppler and gray-scale synovitis supplemented by a detailed report of each examined joint
B) All appropriate sonographic views of every joint examined
C) Images of the sonographic views with the presence of power Doppler synovitis only
D) Images of the sonographic views with the presence of power Doppler and/or gray-scale synovitis only

2. What is the MAXIMUM normal distance between the markers in this plantar longitudinal view of the foot?

A) 7.3 mm
B) 9.3 mm
C) 3.3 mm
D) 5.3 mm

3. A 38-year-old woman with recent history of right shoulder subacromial impingement presents for a two-week follow-up after an anatomically guided subacromial/subdeltoid corticosteroid injection. She reports some initial, but only short-lived, improvement of her right shoulder pain and discomfort with arm elevation.
Her right shoulder X-rays are normal. What would be the MOST appropriate next intervention?

A) Referral to occupational therapy for shoulder rehabilitation exercise
B) Anatomically guided corticosteroid reinjection of the right shoulder subacromial/subdeltoid bursa
C) Ultrasound-guided corticosteroid injection of the glenohumeral joint
D) Ultrasound-guided corticosteroid injection of the right shoulder subacromial/subdeltoid bursa

4. The use of ultrasound investigation to diagnose which of the following pathologic conditions is currently supported by adequate published scientific evidence?

A) Polymyositis
B) Shoulder capsulitis
C) Sjogren's syndrome
D) Eosinophilic fasciitis

5. A scratch along the rubber sole of a transducer is MOST likely to cause which of the following?

A) No impact on image acquisition
B) Increased risk of the spread of infection
C) Risk of electrical shock
D) Artifact in the B-Mode image

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