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American College of Rheumatology RhMSUS Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Upper Extremity Ultrasound | - Elbow, wrist, and hand structures - Shoulder joint evaluation |
| Foundations of Musculoskeletal Ultrasound | - Image optimization and acquisition techniques - Ultrasound physics and instrumentation |
| Ultrasound-Guided Procedures | - Joint aspiration and injection techniques - Needle guidance and safety principles |
| Inflammatory and Degenerative Pathology | - Tendinopathy and enthesitis patterns - Synovitis, effusions, and erosions |
| Lower Extremity Ultrasound | - Hip joint assessment - Knee, ankle, and foot evaluation |
American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology Sample Questions:
1. In performing an in-plane ultrasound-guided procedure, it is helpful to orient the transducer so that the:
A) Needle crosses the plane of the transducer.
B) Needle angle relative to the transducer is minimized.
C) Transducer touches the point where the needle penetrates the skin.
D) Target is as close as possible to the side of the transducer where the needle will be inserted.
2. A practitioner reviews this long-axis ultrasound image of the medial aspect of the knee. Which of the following is the MOST likely differential diagnosis?
A) Osteoarthritis with bone spur and extrusion of the medial meniscus
B) Rheumatoid arthritis with erosion formation
C) No sonographic evidence for abnormality
D) Topheaceous gout with displacement of the medial collateral ligament
3. Which of the following structures for injection has the BEST evidence for the superiority of ultrasound guidance over palpation alone?
A) Glenohumeral joint
B) Flexor digitorum tendon at the A1 pulley
C) Trochanteric bursa
D) Subacromial bursa
4. What should be taken into consideration prior to any procedure?
A) The needle should be visualized only prior to its insertion to the target area.
B) A slight to-and-fro movement or injection of a small amount of lidocaine may be beneficial in visualizing the needle.
C) The transducer should be aligned perpendicular to the plane of the needle.
D) The shortest pathway to the region of interest should be selected with consideration given to adjacent neurovascular structures.
5. An 81-year-old male with known shoulder osteoarthritis presents to the office for an ultrasound-guided injection of the glenohumeral joint. Prior to injection, where should the needle tip be visualized?
A) A
B) D
C) C
D) B
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: A | Question # 3 Answer: A | Question # 4 Answer: D | Question # 5 Answer: B |




