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

1. A 38-year-old woman with recent history of right shoulder subacromial impingement presents for a two-week follow-up after an anatomically guided subacromial/subdeltoid corticosteroid injection. She reports some initial, but only short-lived, improvement of her right shoulder pain and discomfort with arm elevation.
Her right shoulder X-rays are normal. What would be the MOST appropriate next intervention?

A) Ultrasound-guided corticosteroid injection of the glenohumeral joint
B) Ultrasound-guided corticosteroid injection of the right shoulder subacromial/subdeltoid bursa
C) Referral to occupational therapy for shoulder rehabilitation exercise
D) Anatomically guided corticosteroid reinjection of the right shoulder subacromial/subdeltoid bursa

2. In performing an in-plane ultrasound-guided procedure, it is helpful to orient the transducer so that the:

A) Target is as close as possible to the side of the transducer where the needle will be inserted.
B) Transducer touches the point where the needle penetrates the skin.
C) Needle crosses the plane of the transducer.
D) Needle angle relative to the transducer is minimized.

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

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

4. Which pathologic condition is MOST likely responsible for the etiology of shoulder pain in the patient?

A) Calcific tendinitis
B) Rheumatoid synovitis
C) Subacromial bursitis
D) Osteoarthritis

5. In this image of a knee, what is the MOST obvious abnormality?

A) Avascular necrosis
B) Cartilage interface sign
C) Asymmetric femoral cartilage thinning
D) Chondrocalcinosis

Solutions: