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

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

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

2. A 38-year-old woman with recent history of right shoulder subacromial impingement presents for a two-week follow-up after an anatomically guided subacromial/subdeltoid corticosteroid injection. She reports some initial, but only short-lived, improvement of her right shoulder pain and discomfort with arm elevation.
Her right shoulder X-rays are normal. What would be the MOST appropriate next intervention?

A) Ultrasound-guided corticosteroid injection of the glenohumeral joint
B) Referral to occupational therapy for shoulder rehabilitation exercise
C) Anatomically guided corticosteroid reinjection of the right shoulder subacromial/subdeltoid bursa
D) Ultrasound-guided corticosteroid injection of the right shoulder subacromial/subdeltoid bursa

3. For which of the following clinical scenarios is it appropriate for a practitioner to perform musculoskeletal ultrasound?

A) A patient who has pain and numbness over the lateral calf
B) A patient with psoriasis and posterior heel pain
C) A 40-year-old man with a snapping sensation in his groin with hip flexion and external rotation
D) A 50-year-old woman with pain between the third and fourth metatarsals

4. Which of the following is TRUE for document storage and record-keeping guidelines and requirements?

A) There must be provisions for the storage and retrieval of examination records of all studies that are documented in the medical chart.
B) Ultrasound studies must be saved in a DICOM (Digital Imaging and Communications in Medicine) format.
C) All images must be part of the electronic or paper patient file.
D) The physician's report on the ultrasound examination must be stored in a physically separate location from the machine.

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

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

Solutions: