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

1. Which of the dorsal longitudinal metacarpophalangeal images below MOST suggests the diagnosis of rheumatoid arthritis?

A) An ultrasound image of a human body Description automatically generated


B) A close-up of a black and white image Description automatically generated

C) A close-up of a ultrasound Description automatically generated
D) A close-up of an ultrasound Description automatically generated

2. This is a short-axis scan of the supraspinatus tendon in a normal person. What is the finding marked with the arrow?

A) Calcification of the supraspinatus tendon
B) Subacromial bursa calcification
C) Normal deltoid muscle
D) A probe-generated artifact

3. In setting up an ultrasound machine to examine blood flow, which of the following statements BEST reflects the difference between color Doppler and power Doppler ultrasound?

A) Power Doppler ultrasound is preferable to color Doppler ultrasound to assess flow velocity.
B) Color Doppler ultrasound is preferable to power Doppler ultrasound to assess the amplitude of flow.
C) Power Doppler ultrasound is preferable to color Doppler ultrasound to assess the direction of flow.
D) Color Doppler ultrasound is more dependent on the angle of insonation than power Doppler ultrasound.

4. How reliable is ultrasound as compared to other imaging modalities for diagnosing synovitis in the joints of the fingers?

A) Ultrasound is inferior to MRI but superior to clinical exam in sensitivity.
B) Ultrasound is inferior to MRI but superior to X-ray in sensitivity.
C) Ultrasound is as sensitive as MRI but superior to X-ray.
D) Ultrasound is inferior to MRI and X-ray in sensitivity.

5. Gray-scale and Doppler ultrasound evaluation examination alone would BEST assist in establishing a diagnosis in which of the following scenarios?

A) Asymptomatic hand and wrist joints with bony deformities present in a 60-year-old female with a positive rheumatoid factor and CCP antibody but normal sedimentation rate and C-reactive protein level
B) Sacroiliac joints in a 35-year-old male with early morning low-back pain and positive HLA B27
C) Warm, swollen elbow joint in a 70-year-old lymphoma patient with fevers and a history of an abscess of the thoracic spine
D) Knee in a 72-year-old female with unilateral knee pain, no swelling on examination, and medial narrowing of the joint space on knee radiograph

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