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American College of Rheumatology RhMSUS Exam Syllabus Topics:

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

1. An 83-year-old female with a medical history of congestive heart failure, critical aortic stenosis, end-stage renal disease, and morbid obesity presents to the office with a complaint of right knee pain for two years. The pain is worse with activity and better with rest. She notes no redness, warmth, or swelling in the joint, with no other joints being painful. A physical examination reveals crepitus in the right knee with medial and lateral joint line tenderness of the left knee. X-rays of the right knee from six months ago are consistent with severe tricompartmental osteoarthritis. Due to morbid obesity, visualization of bony landmarks is not possible and the decision is made to proceed with an ultrasound-guided knee injection with a hyaluronic acid derivative.
Prior to injection, where should the needle tip be visualized?

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

2. A 72-year-old male with morbid obesity and a known history of knee osteoarthritis presents for an ultrasound-guided knee injection. From which of the following sites should the needle be inserted so that the needle path can be BEST visualized?

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

3. A 30-year-old female patient with rheumatoid arthritis reports pain at the medial malleolus. The medial side of the ankle is tender and seems to be swollen. How should a practitioner interpret the transverse images at the medial malleolus?

A) Tenosynovitis of the tibialis anterior tendon
B) Tenosynovitis of the flexor digitorum
C) Neurom of the tibiatis posterior nerve
D) Tenosynovitis of the flexor hallucis longus

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

A) The patient has hip synovitis and should be aspirated for synovial fluid analysis and culture and injected with corticosteroids.
B) The patient should be referred for plain radiography to evaluate for femoral neck fracture.
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.

5. What is the MAXIMUM normal dimension of the structure indicated by the line in this image?

A) 9 mm in children less than 5 years old
B) 9 mm in adults
C) 7 mm in adults
D) 7 mm in children less than 5 years old

Solutions: