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Updated: Sep 10, 2026
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American College of Rheumatology RhMSUS Exam Overview:
| Certification Vendor: | American College of Rheumatology (ACR) |
|---|---|
| Exam Name: | Musculoskeletal Ultrasound Certification in Rheumatology (RhMSUS) Examination |
| Exam Number: | RhMSUS |
| Available Languages: | English |
| Exam Format: | Multiple-choice questions, Computer-based exam, Online proctored (varies by testing cycle) |
| Recommended Training: | American College of Rheumatology Musculoskeletal Ultrasound Courses |
| Exam Registration: | ACR RhMSUS Certification Information and Registration |
| Sample Questions: | American College of Rheumatology RhMSUS Sample Questions |
| Exam Way: | Computer-based, typically remotely proctored or at designated testing centers depending on administration cycle. |
| Pre Condition: | Intended for licensed rheumatologists or rheumatology trainees with documented musculoskeletal ultrasound training and supervised clinical experience (specific eligibility requirements may vary by ACR cycle). |
| Official Syllabus URL: | https://rheumatology.org |
American College of Rheumatology RhMSUS Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Lower Extremity Ultrasound | - Knee, ankle, and foot evaluation - Hip joint assessment |
| Inflammatory and Degenerative Pathology | - Tendinopathy and enthesitis patterns - Synovitis, effusions, and erosions |
| Upper Extremity Ultrasound | - Shoulder joint evaluation - Elbow, wrist, and hand structures |
| Ultrasound-Guided Procedures | - Joint aspiration and injection techniques - Needle guidance and safety principles |
| Foundations of Musculoskeletal Ultrasound | - Image optimization and acquisition techniques - Ultrasound physics and instrumentation |
American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology Sample Questions:
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. Synovitis in rheumatoid arthritis.
- B. Osteophytes in osteoarthritis.
- C. Erosions in rheumatoid arthritis.
- D. Articular cartilage damage in osteoarthritis.
Which of the following is required in a report documenting an ultrasound-guided procedure?
- A. Image labeled with exam date, patient identification, image orientation, and image views of the target area
- B. Section detailing ultrasonographic observations of any variations from the normal accompanied by measurements
- C. Image showing needle in the target structure or orthogonal images of the target structure before and after injection
- D. Sections detailing medical indication for procedure, study type (limited versus complete), and overall clinical impressions
Which of the following is the MOST appropriate next step to confirm the presence of pathology in this metacarpophalangeal joint?
- A. Decrease the depth.
- B. Check the transverse plane.
- C. Use a "hockey stick" probe.
- D. Float the probe.
How is the dynamic evaluation for subacromial impingement and adhesive capsulitis performed?
- A. By placing the probe in a transverse position between the greater tuberosity and acromion and asking the patient to raise the arm
- B. By placing the probe in a longitudinal position between the greater tuberosity and acromion and asking the patient to raise the arm.
- C. By placing the probe in a transverse position over the distal clavicle and asking the patient to raise the arm
- D. By placing the probe in a coronal-oblique position over the distal clavicle and asking the patient to raise the arm
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. Topheaceous gout with displacement of the medial collateral ligament
- D. No sonographic evidence for abnormality
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