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American College of Rheumatology RhMSUS Exam Syllabus Topics:

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

1. 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) A posteromedial approach at the level of the joint line
B) A posteromedial approach at the level of the mid-gastrocnemius muscle
C) An anteromedial approach at the level of the joint line
D) A posteromedial approach at the level proximal to the joint line

2. Based on this longitudinal view of the anterior hip in a patient with hip pain, which statement is CORRECT?

A) The patient should be referred for plain radiography to evaluate for femoral neck fracture.
B) The patient has hip synovitis and should be aspirated for synovial fluid analysis and culture and injected with corticosteroids.
C) The patient should be referred for MRI to confirm a paralabral cyst and evaluate for labral tear.
D) The patient has a normal hip joint.

3. Which of the following is required in a report documenting an ultrasound-guided procedure?

A) Image showing needle in the target structure or orthogonal images of the target structure before and after injection
B) Section detailing ultrasonographic observations of any variations from the normal accompanied by measurements
C) Image labeled with exam date, patient identification, image orientation, and image views of the target area
D) Sections detailing medical indication for procedure, study type (limited versus complete), and overall clinical impressions

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

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

A) Reverberation artifact
B) Presence of enthesopathy with hyperemia
C) Tenosynovitis
D) Normal medial genicular artery signal

Solutions: