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

1. At which angle is a dorsal scan of the elbow BEST performed?

A) Flexion of the elbow joint in a 90-degree angle
B) Flexion of the elbow joint in a 60-degree angle
C) Full extension of the elbow joint
D) Flexion of the elbow joint in a 45-degree angle

2. A patient with diabetes presents with right ankle pain and swelling. The practitioner is unsure of the cause and decides to perform a musculoskeletal ultrasound examination. Which of the following in the practitioner's report is the BEST statement of indication for this study?

A) Inflammatory arthritis
B) Ruling out of inflammatory arthritis
C) Ankle pain
D) Ruling out of infection

3. Which of the following is the MOST appropriate approach to use when performing an ultrasound-guided aspiration on a Baker's cyst in the posterior knee of a 76-year-old female patient?

A) A posteromedial approach at the level proximal to the joint line
B) An anteromedial approach at the level of the joint line
C) A posteromedial approach at the level of the joint line
D) A posteromedial approach at the level of the mid-gastrocnemius muscle

4. A 45-year-old man presents to the emergency room for evaluation of right knee pain for the past five days.
He denies a history of trauma and is afebrile on examination. A right knee effusion is noted on exam.
Arthrocentesis is planned and a traditional palpation-guided method is being considered versus an ultrasound-guided technique.
Which of the following is the MOST accurate description of the ultrasound-guided technique in this setting?

A) The ultrasound-guided technique takes additional time to perform.
B) The ultrasound-guided technique increases the overall success rate in obtaining joint fluid aspirate.
C) The ultrasound-guided technique leads to more fluid aspiration among novice physicians.
D) The ultrasound-guided technique results in more pain.

5. What is the BEST assessment of these longitudinal images of the pes anserinus region?

A) Tenosynovitis
B) Reverberation artifact
C) Normal medial genicular artery signal
D) Presence of enthesopathy with hyperemia

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