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

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

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

2. Which of the following statements regarding ultrasound probe care is MOST accurate?

A) Internal-use probes are considered semi-critical devices and require low-level disinfection after each use.
B) Internal-use probes are considered critical devices and require sterilization after each use.
C) External probes, when used without a cover for ultrasound-guided injections or aspiration, are considered semi-critical devices and require low-level disinfection after each use.
D) External probes that come into contact with intact skin are considered noncritical devices and require cleaning with low-level disinfectants after each use.

3. Which of the following protocols would be MOST consistent with a complete routine ultrasound examination of the shoulder?

A) Anterior long- and short-axis views of the biceps tendon
oAnterior views of the pectoralis tendon insertion
oAnterior view of the coracoid ligament and rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior long- and short-axis views of the infraspinatus tendon insertion oAxillary long-axis view with arm raised
B) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oDynamic lateral long-axis assessment of impingement with abduction of the arm oPosterior transverse view of the suprascapular notch oView from cranial at the acromioclavicular joint
C) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLateral views of the subscapularis tendon
oLateral long- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior view of the glenohumeral joint recess oDynamic lateral long-axis assessment of impingement with abduction of the arm
D) Anterior long- and short-axis views of the biceps tendon
oAnterior view of the subscapularis tendon in external rotation
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterolateral view of the infraspinatus tendon oPosterior view of the glenohumeral joint recess oView from cranial at the acromioclavicular joint

4. Which of the following is TRUE for document storage and record-keeping guidelines and requirements?

A) All images must be part of the electronic or paper patient file.
B) Ultrasound studies must be saved in a DICOM (Digital Imaging and Communications in Medicine) format.
C) There must be provisions for the storage and retrieval of examination records of all studies that are documented in the medical chart.
D) The physician's report on the ultrasound examination must be stored in a physically separate location from the machine.

5. A practitioner obtains the following ultrasound image of a patient with a positive rheumatoid factor and normal ESR, CRP, and hand X-rays.

Which of the following options would be an evidence-based statement during a discussion of the management plan?

A) A positive Doppler signal is a predictor of future joint damage.
B) Severe (high-grade) synovial hyperemia, but not mild (low-grade) hyperemia, would be an indication to change therapy.
C) Low-grade synovial hyperemia is found in most patients in clinical remission from rheumatoid arthritis.
D) Hyperemia is suggestive of a septic joint and requires further diagnostic testing.

Solutions: