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

1. A patient with diabetes presents with right ankle pain and swelling. The practitioner is unsure of the cause and decides to perform a musculoskeletal ultrasound examination. Which of the following in the practitioner's report is the BEST statement of indication for this study?

A) Ruling out of inflammatory arthritis
B) Inflammatory arthritis
C) Ankle pain
D) Ruling out of infection

2. Which of the following is TRUE for document storage and record-keeping guidelines and requirements?

A) All images must be part of the electronic or paper patient file.
B) There must be provisions for the storage and retrieval of examination records of all studies that are documented in the medical chart.
C) The physician's report on the ultrasound examination must be stored in a physically separate location from the machine.
D) Ultrasound studies must be saved in a DICOM (Digital Imaging and Communications in Medicine) format.

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) Neurom of the tibiatis posterior nerve
D) Tenosynovitis of the flexor digitorum

4. Which probe is the BEST choice for ultrasound examination of the adult wrist?

A) Linear 20-25 mm, 3-8 MHz transducer
B) Linear 20-25 mm, 10-18 MHz transducer
C) Linear 40-50 mm, 10-18 MHz transducer
D) Linear 40-50 mm, 3-8 MHz transducer

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

Solutions: