Musculoskeletal Ultrasound Certification in Rheumatology

Question 1

A 78-year-old woman presents with three days of ankle pain and swelling. Her exam reveals swelling localized around the medial malleolus, and any motion or palpation causes pain. The medial transverse ultrasound view of the ankle is shown. Based on her presentation and the ultrasound image, what is the MOST likely anatomic structure from which her pain is emanating?

A. Flexor digitorum

B. Flexor hallucis

C. Subtalar joint

D. Posterior tibial tendon

Correct Answer: D

Question 2

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

A. Avascular necrosis

B. Asymmetric femoral cartilage thinning

C. Cartilage interface sign

D. Chondrocalcinosis

Correct Answer: B

Question 3

What is the BEST assessment of these longitudinal images of the pes anserinus region?

A. Tenosynovitis

B. Normal medial genicular artery signal

C. Reverberation artifact

D. Presence of enthesopathy with hyperemia

Correct Answer: A

Question 4

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

A. A patient with psoriasis and posterior heel pain

B. A 40-year-old man with a snapping sensation in his groin with hip flexion and external rotation

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

Correct Answer: B

Question 5

This ultrasound image from a 60-year-old woman with knee pain is MOST suggestive of which of the following?

A. Urate deposition

B. Osteophyte formation

C. Meniscus tear

D. Chondrocalcinosis

Correct Answer: B

Question 6

Which of the following is the MOST appropriate approach to use when performing an ultrasound-guided aspiration on a Baker's cyst in the posterior knee of a 76-year-old female patient?

A. An anteromedial approach at the level of the joint line

B. A posteromedial approach at the level of the joint line

C. A posteromedial approach at the level proximal to the joint line

D. A posteromedial approach at the level of the mid-gastrocnemius muscle

Correct Answer: C

Question 7

Which of the following is MOST likely to cause vertical lines on every image obtained from a piece of ultrasound equipment?

A. Damage to the transducer cable

B. Misaligned time-gain compensation

C. Cracks in the transducer that may indicate breakage of piezoelectric crystal elements

D. Increased number of air bubbles in the transducer gel that may impede sound waves

Correct Answer: D

Question 8

Which condition is the ultrasound examination of this nodular structure MOST suggestive of?

A. Ganglion cyst

B. Gouty tophus

C. Rheumatoid nodule

D. Subcutaneous abscess

Correct Answer: A

Question 9

A 62-year-old man presents with left shoulder pain. The ultrasound image was taken at the patient's maximum abduction (45 degrees). Which of the following rotator cuff pathologies is BEST evaluated with this shoulder position?

A. Enthesopathy

B. Impingement

C. Complete tear

D. Intrasubstance tear

Correct Answer: B

Question 10

In this ultrasound image of a hip, where is the transducer positioned?

A. Parallel to the femoral neck

B. Parallel to the greater trochanter

C. Parallel to the inguinal ligament

D. Parallel to the femoral shaft

Correct Answer: C

American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology - RhMSUS Exam Practice Test

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