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

2. At approximately how many degrees of flexion is the MOST sensitive resting position of the knee for imaging fluid in the suprapatellar recess?

A) 0
B) 15
C) 45
D) 30

3. What is the MAXIMUM normal distance between the markers in this plantar longitudinal view of the foot?

A) 7.3 mm
B) 5.3 mm
C) 3.3 mm
D) 9.3 mm

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

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

5. 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) Calcium pyrophosphate arthritis
B) Gout
C) Rheumatoid arthritis
D) Psoriatic arthritis

Solutions: