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

1. By comparing gray-scale images from before pharmacologic treatment and after months of treatment, rheumatologists are able to assess patient improvement and response with regard to:

A) Articular cartilage damage in osteoarthritis.
B) Erosions in rheumatoid arthritis.
C) Osteophytes in osteoarthritis.
D) Synovitis in rheumatoid arthritis.

2. Which of the probe placement photographs BEST matches the standard wrist ultrasound image shown?

A) Image D
B) Image B
C) Image C
D) Image A

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

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

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

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

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

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