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

1. How is the dynamic evaluation for subacromial impingement and adhesive capsulitis performed?

A) By placing the probe in a longitudinal position between the greater tuberosity and acromion and asking the patient to raise the arm.
B) By placing the probe in a coronal-oblique position over the distal clavicle and asking the patient to raise the arm
C) By placing the probe in a transverse position over the distal clavicle and asking the patient to raise the arm
D) By placing the probe in a transverse position between the greater tuberosity and acromion and asking the patient to raise the arm

2. The best way to facilitate visualization of ultrasound images in an exam room.

A) Brighten the ambient lighting to improve the signal-to-noise ratio
B) Decrease the amount of gel in between transducer and skin to improve transmission of sound waves
C) Decrease high-frequency ambient noise to minimize interfering sound waves
D) Dim the exam room lighting to improve the signal-to-noise ratio (This is the best answer)

3. A 3-year-old child with juvenile idiopathic arthritis presents for an intra-articular corticosteroid injection of the knee. Using ultrasound guidance, which location should be targeted with a needle?

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

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

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

5. What is the appropriate image documentation for an ultrasound study evaluating sonographic synovitis in bilateral hand and wrist joints in a patient with rheumatoid arthritis?

A) Images of the sonographic views with the presence of power Doppler and/or gray-scale synovitis only
B) Images of the sonographic views with the presence of power Doppler synovitis only
C) All appropriate sonographic views of every joint examined
D) Representative sonographic image example of power Doppler and gray-scale synovitis supplemented by a detailed report of each examined joint

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