[Q51-Q71] Updated Dec-2024 Test Engine to Practice Test for RhMSUS Exam Questions and Answers!

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Updated Dec-2024 Test Engine to Practice Test for RhMSUS Exam Questions and Answers!

Musculoskeletal Ultrasound Certification in Rheumatology Certification Sample Questions and Practice Exam

NO.51 In this volar transverse image of the carpal tunnel, the arrows represent needles, and the arrowheads represent the needle tips. In planning a carpal tunnel corticosteroid injection with ultrasound guidance, which of the arrows combines the safest path through tissues with the BEST needle visualization?

Arrow A

Arrow B

Arrow C

Arrow D

NO.52 What is the appropriate image documentation for an ultrasound study evaluating sonographic synovitis in bilateral hand and wrist joints in a patient with rheumatoid arthritis?

Images of the sonographic views with the presence of power Doppler synovitis only

Images of the sonographic views with the presence of power Doppler and/or gray-scale synovitis only

Representative sonographic image example of power Doppler and gray-scale synovitis supplemented by a detailed report of each examined joint

All appropriate sonographic views of every joint examined

NO.53 The use of ultrasound investigation to diagnose which of the following pathologic conditions is currently supported by adequate published scientific evidence?

Shoulder capsulitis

Polymyositis

Sjogren’s syndrome

Eosinophilic fasciitis

NO.54 Which of the following should NOT be evaluated using a musculoskeletal ultrasound?”

Hand joints for progression of erosive disease in a patient with established rheumatoid arthritis

A femoral neck enchondroma in a patient complaining of hip pain

Salivary gland parenchyma in a patient suspected of having Sjogren’s syndrome

A Morton’s neuroma in a patient complaining of foot pain

NO.55 Which of the following protocols would be MOST consistent with a complete routine ultrasound examination of the shoulder?

Anterior long- and short-axis views of the biceps tendon
oAnterior view of the subscapularis tendon in external rotation
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterolateral view of the infraspinatus tendon oPosterior view of the glenohumeral joint recess oView from cranial at the acromioclavicular joint

Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLateral views of the subscapularis tendon
oLateral long- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior view of the glenohumeral joint recess oDynamic lateral long-axis assessment of impingement with abduction of the arm

Anterior long- and short-axis views of the biceps tendon
oAnterior views of the pectoralis tendon insertion
oAnterior view of the coracoid ligament and rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oPosterior long- and short-axis views of the infraspinatus tendon insertion oAxillary long-axis view with arm raised

Anterior long- and short-axis views of the biceps tendon
oAnterior view of the rotator cuff interval
oLong- and short-axis views of the supraspinatus tendon, moving the transducer anteriorly and posteriorly oDynamic lateral long-axis assessment of impingement with abduction of the arm oPosterior transverse view of the suprascapular notch oView from cranial at the acromioclavicular joint

NO.56 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?

An anteromedial approach at the level of the joint line

A posteromedial approach at the level of the joint line

A posteromedial approach at the level proximal to the joint line

A posteromedial approach at the level of the mid-gastrocnemius muscle

NO.57 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 positive Doppler signal is a predictor of future joint damage.

Hyperemia is suggestive of a septic joint and requires further diagnostic testing.

Severe (high-grade) synovial hyperemia, but not mild (low-grade) hyperemia, would be an indication to change therapy.

Low-grade synovial hyperemia is found in most patients in clinical remission from rheumatoid arthritis.

NO.58 Gray-scale and Doppler ultrasound evaluation examination alone would BEST assist in establishing a diagnosis in which of the following scenarios?

Sacroiliac joints in a 35-year-old male with early morning low-back pain and positive HLA B27

Warm, swollen elbow joint in a 70-year-old lymphoma patient with fevers and a history of an abscess of the thoracic spine

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

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

NO.59 This ultrasound image from a 60-year-old woman with knee pain is MOST suggestive of which of the following?

Urate deposition

Meniscus tear

Chondrocalcinosis

Osteophyte formation

NO.60 A 78-year-old woman presents with three days of ankle pain and swelling. Her exam reveals swelling localized around the medial malleolus, and any motion or palpation causes pain. The medial transverse ultrasound view of the ankle is shown. Based on her presentation and the ultrasound image, what is the MOST likely anatomic structure from which her pain is emanating?

Posterior tibial tendon

Flexor digitorum

Flexor hallucis

Subtalar joint

NO.61 What is the BEST description for this longitudinal ultrasound scan of a 75-year-old patient with pain in the medial aspect of the knee?

Osteophytes and meniscal cyst

Osteophytes and rupture of the medial collateral ligament

Osteophytes and distension and calcification of the medial collateral ligament

Osteophytes, distension of the medial collateral ligament, and meniscal degeneration

NO.62 A woman with a history of long-standing rheumatoid arthritis presents with persistent, chronic wrist pain and swelling. What do the patient’s ultrasound images demonstrate?

Rheumatoid nodulosis

Extensor tendon tear

Extensor tenosynovitis

Ganglion cyst rupture

NO.63 In imaging the volar wrist in transverse, this Doppler view helps confirm the presence of which of the following?

Median nerve impingement

Persistent median artery

Flexor tenosynovitis

Anomalous radial artery

NO.64 Which pathologic condition is MOST likely responsible for the etiology of shoulder pain in the patient?

Rheumatoid synovitis

Osteoarthritis

Calcific tendinitis

Subacromial bursitis

NO.65 What is the MAXIMUM normal dimension of the structure indicated by the line in this image?

7 mm in children less than 5 years old

7 mm in adults

9 mm in children less than 5 years old

9 mm in adults

NO.66 What is the BEST assessment of these longitudinal images of the pes anserinus region?

Presence of enthesopathy with hyperemia

Reverberation artifact

Normal medial genicular artery signal

Tenosynovitis

NO.67 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?

Gout

Calcium pyrophosphate arthritis

Rheumatoid arthritis

Psoriatic arthritis

NO.68 Which of the following is shown in this longitudinal image of the talonavicular-cuneiform joints in a
15-year-old girl?

The typical appearance of pes equinovarus

The normal appearance of irregular ossification centers of the respective midfoot bones

Irregularities of the respective midfoot bones indicative of damage as well as surrounding areas indicative of synovial hypertrophy and effusions

An inflammatory process in the subcutaneous tissues, possibly an infection, extending into the joint spaces

NO.69 For which of the following conditions is the use of diagnostic musculoskeletal ultrasound appropriate?

Anterior cruciate ligament tear

Meniscal tear

Osgood-Schlatter disease

Tibial stress fracture

NO.70 A practitioner wants to assess the structure marked with an asterisk (*).

What maneuver should the practitioner instruct the patient to perform of the examined joint?