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American College of Rheumatology RhMSUS Exam Syllabus Topics:

Section	Objectives
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	- Synovitis, effusions, and erosions - Tendinopathy and enthesitis patterns
Lower Extremity Ultrasound	- Hip joint assessment - Knee, ankle, and foot evaluation
Upper Extremity Ultrasound	- Shoulder joint evaluation - Elbow, wrist, and hand structures

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

1. In which situation is an ultrasound MOST appropriate for making the correct clinical diagnosis?

A) In rheumatoid arthritis, to diagnose carpal tunnel syndrome
B) In fibromyalgia, to confirm the absence of joint and tendon pathology
C) In gout, using the double contour sign alone as diagnostic confirmation of the disease
D) In juvenile idiopathic arthritis, to diagnose tenosynovitis in a patient with ankle swelling

2. A practitioner is counseling a patient with suspected rotator cuff tendinopathy on imaging options. Which of the following is CORRECT regarding diagnostic ultrasound examination?

A) It provides the same information as an MRI without gadolinium.
B) It obviates the need for X-ray examination when cortical margins are normal.
C) It is the gold standard for preoperative planning for rotator cuff surgery.
D) It uses sound energy with no adverse effects found in clinical studies.

3. 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) Erosions in rheumatoid arthritis.
C) Articular cartilage damage in osteoarthritis.
D) Synovitis in rheumatoid arthritis.

4. Which situation represents the MOST appropriate indication for a practitioner to perform a musculoskeletal ultrasound in clinical practice?

A) Assessment of pain and swelling of unclear etiology at the right temporomandibular joint
B) Evaluation of shoulder pain in a patient with diabetes most likely related to adhesive capsulitis
C) Assessment of asymptomatic entheses in a patient with pain at the acromioclavicular joint
D) Preoperative evaluation of a patient with suspected rotator cuff tear

5. Which of the following images shows the CORRECT positioning for an ultrasound examination of the infraspinatus tendon?

A) A person sitting in front of a machine Description automatically generated
B) A person in a hospital room Description automatically generated with medium confidence

C) A person with no shirt Description automatically generated
D) A person sitting in a chair with a machine Description automatically generated