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

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

2. Which statement is TRUE regarding the techniques that can minimize infection during ultrasound-guided procedures?

A) The needle can touch the uncovered probe during the procedure as long as sterile gel is used.
B) Povidone iodine swab of the injection site has been demonstrated to be insufficient to minimize infection during ultrasound-guided arthrocentesis.
C) Sterile probe covers with sterile coupling gel can be employed during intra-articular injections, particularly those that require close proximity between the transducer and the needle tip.
D) Not using probe covers during ultrasound-guided arthrocentesis has been demonstrated to lead to increased rates of joint infections.

3. What is the MAIN pathologic finding shown in this ultrasound image?

A) Osteophytes
B) Synovitis
C) Tendon rupture
D) Erosion

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

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

5. Which of the following is MOST accurate regarding high-level disinfection of a probe?

A) High-level disinfection of an internal-use probe is required between every patient
B) High-level disinfection of an external probe is mandatory between patients after ultrasound-guided arthrocentesis, regardless of probe cover
C) High-level disinfection of an external probe removes all bacterial spores.
D) High-level disinfection of an external probe does not remove most fungi

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