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

1. How reliable is ultrasound as compared to other imaging modalities for diagnosing synovitis in the joints of the fingers?

A) Ultrasound is as sensitive as MRI but superior to X-ray.
B) Ultrasound is inferior to MRI and X-ray in sensitivity.
C) Ultrasound is inferior to MRI but superior to X-ray in sensitivity.
D) Ultrasound is inferior to MRI but superior to clinical exam in sensitivity.

2. In this volar transverse image of the carpal tunnel, the arrows represent needles, and the arrowheads represent the needle tips. In planning a carpal tunnel corticosteroid injection with ultrasound guidance, which of the arrows combines the safest path through tissues with the BEST needle visualization?

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

3. A 30-year-old pregnant woman with rheumatoid arthritis presents with right wrist pain and swelling despite a palpation-guided corticosteroid injection one month ago.

A) Radiocarpal joint
B) Radioulnar joint
C) Intercarpal joint
D) Extensor tenosynovium

4. This image shows the sequence of a guided procedure in a patient with rheumatoid arthritis and a mass of the right shoulder. Although guided aspiration was useful for the fluid examination, surgery was performed for a definitive diagnosis of the acromioclavicular cyst. Which condition is the finding MOST associated with this pathology?

A) Chondrocalcinosis
B) Humeral head fracture
C) Amyloidosis
D) Rotator cuff tear

5. What is the MOST prominent ultrasound artifact depicted in this image?

A) Shadowing
B) Enhancement
C) Comet tail
D) Ring down

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