Musculoskeletal Ultrasound Certification in Rheumatology (RhMSUS) Free Practice Test

Question 1

A 80-year-old man presents with two weeks of wrist swelling and pain. His exam reveals swelling and tenderness over the dorsum of his right wrist as well as synovial swelling of the second and third metacarpophalangeal joints of his left hand. His serum uric acid concentration is 6.0 mg/dL. The longitudinal and transverse images of the dorsal aspect of his right wrist are shown below. What is the MOST likely diagnosis?

A. Rheumatoid arthritis

B. Gout

C. Psoriatic arthritis

D. Calcium pyrophosphate arthritis

Correct Answer: B

Question 2

The use of ultrasound investigation to diagnose which of the following pathologic conditions is currently supported by adequate published scientific evidence?

A. Eosinophilic fasciitis

B. Shoulder capsulitis

C. Polymyositis

D. Sjogren's syndrome

Correct Answer: B

Question 3

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

A. Sections detailing medical indication for procedure, study type (limited versus complete), and overall clinical impressions

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. Image showing needle in the target structure or orthogonal images of the target structure before and after injection

Correct Answer: A

Question 4

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 flexor hallucis longus

B. Tenosynovitis of the flexor digitorum

C. Neurom of the tibiatis posterior nerve

D. Tenosynovitis of the tibialis anterior tendon

Correct Answer: A

Question 5

Which pathologic condition is MOST likely responsible for the etiology of shoulder pain in the patient?

A. Rheumatoid synovitis

B. Osteoarthritis

C. Calcific tendinitis

D. Subacromial bursitis

Correct Answer: D

Question 6

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

A. Reverberation artifact

B. Presence of enthesopathy with hyperemia

C. Normal medial genicular artery signal

D. Tenosynovitis

Correct Answer: D

Question 7

A practitioner wants to assess the structures on the right, distal portion of this image.

What should the practitioner do at this time?

A. Place the focal point at the level of the area of interest.

B. Depress the distal end of the probe.

C. Increase the overall gain to brighten the image.

D. Choose a lower transducer frequency.

Correct Answer: A

Question 8

Which of the following anatomic structures BEST fits the scope of rheumatologic ultrasound practice?

A. Posterior cruciate ligament

B. Anterior glenoid labrum

C. Metacarpal volar plate

D. Posterior patellar cartilage

Correct Answer: D

Question 9

Which is the MAIN pathologic finding shown by this ultrasound picture in a patient with psoriatic arthritis?

A. Proximal interphalangeal osteophytes

B. Proximal interphalangeal synovitis

C. Flexor tendon rupture with reparative hyperemia

D. Flexor tenosynovitis

Correct Answer: D

Question 10

By comparing gray-scale images from before pharmacologic treatment and after months of treatment, rheumatologists are able to assess patient improvement and response with regard to:

A. Osteophytes in osteoarthritis.

B. Articular cartilage damage in osteoarthritis.

C. Synovitis in rheumatoid arthritis.

D. Erosions in rheumatoid arthritis.

Correct Answer: C

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American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology (RhMSUS) Free Practice Test