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

1. Which of the following structures for injection has the BEST evidence for the superiority of ultrasound guidance over palpation alone?

A) Flexor digitorum tendon at the A1 pulley
B) Glenohumeral joint
C) Subacromial bursa
D) Trochanteric bursa

2. Which of the following anatomic structures BEST fits the scope of rheumatologic ultrasound practice?

A) Posterior patellar cartilage
B) Metacarpal volar plate
C) Anterior glenoid labrum
D) Posterior cruciate ligament

3. Ultrasound is the MOST appropriate tool to evaluate which of these structures for pathology?

A) Sacroiliac joint in a patient with positive HLA B27 and inflammatory-type lower back pain, assessing for joint space narrowing
B) Cartilage loss quantification in a patient with osteoarthritis
C) Temporomandibular joint in a patient with juvenile idiopathic arthritis, assessing for erosions
D) Achilles tendon insertion site in a patient with spondyloarthropathy, assessing for enthesopathy

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

5. Which of the dorsal longitudinal metacarpophalangeal images below MOST suggests the diagnosis of rheumatoid arthritis?

A) An ultrasound image of a human body Description automatically generated


B) A close-up of an ultrasound Description automatically generated

C) A close-up of a black and white image Description automatically generated

D) A close-up of a ultrasound Description automatically generated

Solutions: