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

1. In performing an in-plane ultrasound-guided procedure, it is helpful to orient the transducer so that the:

A) Needle angle relative to the transducer is minimized.
B) Transducer touches the point where the needle penetrates the skin.
C) Target is as close as possible to the side of the transducer where the needle will be inserted.
D) Needle crosses the plane of the transducer.

2. Which of the following protocols would be MOST consistent with a complete routine ultrasound examination of the shoulder?

A) Anterior long- and short-axis views of the biceps tendon
oAnterior views of the pectoralis tendon insertion
oAnterior view of the coracoid ligament and rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior long- and short-axis views of the infraspinatus tendon insertion oAxillary long-axis view with arm raised
B) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oDynamic lateral long-axis assessment of impingement with abduction of the arm oPosterior transverse view of the suprascapular notch oView from cranial at the acromioclavicular joint
C) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the subscapularis tendon in external rotation
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterolateral view of the infraspinatus tendon oPosterior view of the glenohumeral joint recess oView from cranial at the acromioclavicular joint
D) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLateral views of the subscapularis tendon
oLateral long- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior view of the glenohumeral joint recess oDynamic lateral long-axis assessment of impingement with abduction of the arm

3. In imaging the volar wrist in transverse, this Doppler view helps confirm the presence of which of the following?

A) Persistent median artery
B) Median nerve impingement
C) Anomalous radial artery
D) Flexor tenosynovitis

4. What should be taken into consideration prior to any procedure?

A) The transducer should be aligned perpendicular to the plane of the needle.
B) The shortest pathway to the region of interest should be selected with consideration given to adjacent neurovascular structures.
C) A slight to-and-fro movement or injection of a small amount of lidocaine may be beneficial in visualizing the needle.
D) The needle should be visualized only prior to its insertion to the target area.

5. What is the BEST description for this longitudinal ultrasound scan of a 75-year-old patient with pain in the medial aspect of the knee?

A) Osteophytes and meniscal cyst
B) Osteophytes and rupture of the medial collateral ligament
C) Osteophytes and distension and calcification of the medial collateral ligament
D) Osteophytes, distension of the medial collateral ligament, and meniscal degeneration

Solutions: