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

1. Which statement is TRUE regarding the techniques that can minimize infection during ultrasound-guided procedures?

A) Sterile probe covers with sterile coupling gel can be employed during intra-articular injections, particularly those that require close proximity between the transducer and the needle tip.
B) Not using probe covers during ultrasound-guided arthrocentesis has been demonstrated to lead to increased rates of joint infections.
C) Povidone iodine swab of the injection site has been demonstrated to be insufficient to minimize infection during ultrasound-guided arthrocentesis.
D) The needle can touch the uncovered probe during the procedure as long as sterile gel is used.

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

A) 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
B) Warm, swollen elbow joint in a 70-year-old lymphoma patient with fevers and a history of an abscess of the thoracic spine
C) Sacroiliac joints in a 35-year-old male with early morning low-back pain and positive HLA B27
D) 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

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

A) Increased number of air bubbles in the transducer gel that may impede sound waves
B) Misaligned time-gain compensation
C) Damage to the transducer cable
D) Cracks in the transducer that may indicate breakage of piezoelectric crystal elements

4. A 3-year-old child with juvenile idiopathic arthritis presents for an intra-articular corticosteroid injection of the knee. Using ultrasound guidance, which location should be targeted with a needle?

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

5. Which effect is achieved by increasing the gain while in Doppler mode?

A) Increased sensitivity to flow
B) Increased tissue penetration
C) Reduced noise artifacts in the image
D) Increased image brightness

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