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

1. Which of the following is shown in this longitudinal image of the talonavicular-cuneiform joints in a
15-year-old girl?

A) An inflammatory process in the subcutaneous tissues, possibly an infection, extending into the joint spaces
B) The typical appearance of pes equinovarus
C) Irregularities of the respective midfoot bones indicative of damage as well as surrounding areas indicative of synovial hypertrophy and effusions
D) The normal appearance of irregular ossification centers of the respective midfoot bones

2. Which is the MAIN pathologic finding shown by this ultrasound picture in a patient with psoriatic arthritis?

A) Flexor tendon rupture with reparative hyperemia
B) Proximal interphalangeal synovitis
C) Proximal interphalangeal osteophytes
D) Flexor tenosynovitis

3. Which of these supraspinatus longitudinal images has the BEST combination of ultrasound machine settings?

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

4. What is the BEST description for this longitudinal ultrasound scan of a 75-year-old patient with pain in the medial aspect of the knee?

A) Osteophytes, distension of the medial collateral ligament, and meniscal degeneration
B) Osteophytes and meniscal cyst
C) Osteophytes and distension and calcification of the medial collateral ligament
D) Osteophytes and rupture of the medial collateral ligament

5. A 30-year-old female patient with rheumatoid arthritis reports pain at the medial malleolus. The medial side of the ankle is tender and seems to be swollen. How should a practitioner interpret the transverse images at the medial malleolus?

A) Neurom of the tibiatis posterior nerve
B) Tenosynovitis of the flexor hallucis longus
C) Tenosynovitis of the flexor digitorum
D) Tenosynovitis of the tibialis anterior tendon

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