American College of Rheumatology RhMSUS : Musculoskeletal Ultrasound Certification in Rheumatology

  • Exam Code: RhMSUS
  • Exam Name: Musculoskeletal Ultrasound Certification in Rheumatology
  • Updated: Sep 09, 2026
  • Q & A: 100 Questions and Answers

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American College of Rheumatology RhMSUS Exam Syllabus Topics:

SectionObjectives
Upper Extremity Ultrasound- Shoulder joint evaluation
- Elbow, wrist, and hand structures
Ultrasound-Guided Procedures- Needle guidance and safety principles
- Joint aspiration and injection techniques
Inflammatory and Degenerative Pathology- Tendinopathy and enthesitis patterns
- Synovitis, effusions, and erosions
Foundations of Musculoskeletal Ultrasound- Image optimization and acquisition techniques
- Ultrasound physics and instrumentation
Lower Extremity Ultrasound- Hip joint assessment
- Knee, ankle, and foot evaluation

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

Question #1

Ultrasound evaluation of a painful shoulder is MOST likely to be useful in planning a corticosteroid injection for which of the following conditions?

  • A. Glenohumeral synovitis
  • B. Adhesive capsulitis
  • C. Superior labral anterior-posterior lesion
  • D. Complex regional pain syndrome
Answer: A
Question #2

A 72-year-old male with morbid obesity and a known history of knee osteoarthritis presents for an ultrasound-guided knee injection. From which of the following sites should the needle be inserted so that the needle path can be BEST visualized?

  • A. B
  • B. C
  • C. D
  • D. A
Answer: A
Question #3

An 83-year-old female with a medical history of congestive heart failure, critical aortic stenosis, end-stage renal disease, and morbid obesity presents to the office with a complaint of right knee pain for two years. The pain is worse with activity and better with rest. She notes no redness, warmth, or swelling in the joint, with no other joints being painful. A physical examination reveals crepitus in the right knee with medial and lateral joint line tenderness of the left knee. X-rays of the right knee from six months ago are consistent with severe tricompartmental osteoarthritis. Due to morbid obesity, visualization of bony landmarks is not possible and the decision is made to proceed with an ultrasound-guided knee injection with a hyaluronic acid derivative.
Prior to injection, where should the needle tip be visualized?

  • A. B
  • B. C
  • C. D
  • D. A
Answer: A
Question #4

Which effect is achieved by increasing the gain while in Doppler mode?

  • A. Increased sensitivity to flow
  • B. Increased image brightness
  • C. Reduced noise artifacts in the image
  • D. Increased tissue penetration
Answer: A
Question #5

Which of the following is required in a report documenting an ultrasound-guided procedure?

  • A. Section detailing ultrasonographic observations of any variations from the normal accompanied by measurements
  • B. Image labeled with exam date, patient identification, image orientation, and image views of the target area
  • C. Sections detailing medical indication for procedure, study type (limited versus complete), and overall clinical impressions
  • D. Image showing needle in the target structure or orthogonal images of the target structure before and after injection
Answer: C

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