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

1. In performing an in-plane ultrasound-guided procedure, it is helpful to orient the transducer so that the:

A) Transducer touches the point where the needle penetrates the skin.
B) Target is as close as possible to the side of the transducer where the needle will be inserted.
C) Needle crosses the plane of the transducer.
D) Needle angle relative to the transducer is minimized.

2. 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) Psoriatic arthritis
C) Gout
D) Calcium pyrophosphate arthritis

3. Which condition is the ultrasound examination of this nodular structure MOST suggestive of?

A) Subcutaneous abscess
B) Gouty tophus
C) Rheumatoid nodule
D) Ganglion cyst

4. In setting up an ultrasound machine to examine blood flow, which of the following statements BEST reflects the difference between color Doppler and power Doppler ultrasound?

A) Power Doppler ultrasound is preferable to color Doppler ultrasound to assess the direction of flow.
B) Color Doppler ultrasound is preferable to power Doppler ultrasound to assess the amplitude of flow.
C) Color Doppler ultrasound is more dependent on the angle of insonation than power Doppler ultrasound.
D) Power Doppler ultrasound is preferable to color Doppler ultrasound to assess flow velocity.

5. Which probe is the BEST choice for ultrasound examination of the adult wrist?

A) Linear 20-25 mm, 10-18 MHz transducer
B) Linear 40-50 mm, 10-18 MHz transducer
C) Linear 20-25 mm, 3-8 MHz transducer
D) Linear 40-50 mm, 3-8 MHz transducer

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