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Updated: Sep 04, 2025

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

1. In setting up an ultrasound machine to examine blood flow, which of the following statements BEST reflects the difference between color Doppler and power Doppler ultrasound?

A) Power Doppler ultrasound is preferable to color Doppler ultrasound to assess flow velocity.
B) Power Doppler ultrasound is preferable to color Doppler ultrasound to assess the direction of flow.
C) Color Doppler ultrasound is more dependent on the angle of insonation than power Doppler ultrasound.
D) Color Doppler ultrasound is preferable to power Doppler ultrasound to assess the amplitude of flow.


2. Proper maintenance of ultrasound equipment between use for each patient is important to prevent which of the following?

A) Infection
B) Poor calibration
C) Examiner injury
D) Radiation exposure


3. Which condition is the ultrasound examination of this nodular structure MOST suggestive of?

A) Subcutaneous abscess
B) Ganglion cyst
C) Rheumatoid nodule
D) Gouty tophus


4. A photograph of an ultrasound-guided injection approach is shown below. With which ultrasound image does it BEST correlate?

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


5. A 37-year-old female with a history of rheumatoid arthritis presents for sonographic evaluation. She has been in clinical remission for six months and is considering discontinuation of her biologic agent. Sonography of the right third metacarpophalangeal joint is shown. Which of the following is the MOST accurate description regarding this image?

A) Abnormal hypoechoic intra-articular tissue with Doppler signal
B) Abnormal hyperechoic intra-articular tissue with Doppler signal
C) Abnormal hypoechoic extra-articular tissue with Doppler signal
D) Abnormal hyperechoic extra-articular tissue with Doppler signal


Solutions:

Question # 1
Answer: C
Question # 2
Answer: A
Question # 3
Answer: B
Question # 4
Answer: A
Question # 5
Answer: A

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