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

1. What is the MAXIMUM normal dimension of the structure indicated by the line in this image?

A) 7 mm in adults
B) 7 mm in children less than 5 years old
C) 9 mm in adults
D) 9 mm in children less than 5 years old

2. 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) Rheumatoid arthritis
C) Psoriatic arthritis
D) Calcium pyrophosphate arthritis

3. A 72-year-old male with morbid obesity and a known history of knee osteoarthritis presents for an ultrasound-guided knee injection. From which of the following sites should the needle be inserted so that the needle path can be BEST visualized?

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

4. 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

5. What is the MAIN pathologic finding shown in this ultrasound image?

A) Osteophytes
B) Erosion
C) Tendon rupture
D) Synovitis

Solutions: