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

1. Why is musculoskeletal ultrasound (MSKUS) useful in monitoring the treatment response in rheumatoid arthritis?

A) Gray-scale ultrasound can predict the development of erosions.
B) Power Doppler ultrasound is specific to rheumatoid arthritis disease activity.
C) MSKUS is able to detect bone marrow edema around joints
D) Power Doppler ultrasound is sensitive to change in disease activity.

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) Calcium pyrophosphate arthritis
B) Rheumatoid arthritis
C) Gout
D) Psoriatic arthritis

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

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

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

5. A practitioner is counseling a patient with suspected rotator cuff tendinopathy on imaging options. Which of the following is CORRECT regarding diagnostic ultrasound examination?

A) It provides the same information as an MRI without gadolinium.
B) It is the gold standard for preoperative planning for rotator cuff surgery.
C) It uses sound energy with no adverse effects found in clinical studies.
D) It obviates the need for X-ray examination when cortical margins are normal.

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