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

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

2. What is the MAIN pathologic finding shown in this ultrasound image?

A) Osteophytes
B) Erosion
C) Tendon rupture
D) Synovitis

3. A 37-year-old female with a history of rheumatoid arthritis presents for sonographic evaluation. She has been in clinical remission for six months and is considering discontinuation of her biologic agent. Sonography of the right third metacarpophalangeal joint is shown. Which of the following is the MOST accurate description regarding this image?

A) Abnormal hyperechoic extra-articular tissue with Doppler signal
B) Abnormal hyperechoic intra-articular tissue with Doppler signal
C) Abnormal hypoechoic extra-articular tissue with Doppler signal
D) Abnormal hypoechoic intra-articular tissue with Doppler signal

4. Which pathologic condition is MOST likely responsible for the etiology of shoulder pain in the patient?

A) Osteoarthritis
B) Calcific tendinitis
C) Subacromial bursitis
D) Rheumatoid synovitis

5. What is the position of the arm MOST likely used to obtain this B-Mode image of the shoulder?

A) External rotation
B) Neer impingement
C) Crass
D) Modified Crass

Solutions: