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

1. Which of the following should NOT be evaluated using a musculoskeletal ultrasound?"

A) Hand joints for progression of erosive disease in a patient with established rheumatoid arthritis
B) Salivary gland parenchyma in a patient suspected of having Sjogren's syndrome
C) A Morton's neuroma in a patient complaining of foot pain
D) A femoral neck enchondroma in a patient complaining of hip pain

2. How reliable is ultrasound as compared to other imaging modalities for diagnosing synovitis in the joints of the fingers?

A) Ultrasound is inferior to MRI but superior to X-ray in sensitivity.
B) Ultrasound is as sensitive as MRI but superior to X-ray.
C) Ultrasound is inferior to MRI but superior to clinical exam in sensitivity.
D) Ultrasound is inferior to MRI and X-ray in sensitivity.

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

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

4. A 41-year-old man presents with suspected right carpal tunnel syndrome but normal nerve conduction studies. For which reason will a sonographic study be helpful for further diagnostic evaluation?

A) Ultrasound can identify the underlying etiology of carpal tunnel syndrome.
B) Concurrent use of nerve conduction studies and ultrasonography increases diagnostic sensitivity of mild carpal tunnel syndrome.
C) Compared to nerve conduction studies, ultrasound is more sensitive for the diagnosis of mild carpal tunnel syndrome.
D) Ultrasound can delineate volar wrist anatomy.

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

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

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