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Updated: Jul 28, 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 |
| Exam Format: | Computer-based exam, Multiple-choice questions, Online proctored (varies by testing cycle) |
| Available Languages: | English |
| 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 |
|---|---|
| Foundations of Musculoskeletal Ultrasound | - Ultrasound physics and instrumentation - Image optimization and acquisition techniques |
| Inflammatory and Degenerative Pathology | - Tendinopathy and enthesitis patterns - Synovitis, effusions, and erosions |
| Ultrasound-Guided Procedures | - Needle guidance and safety principles - Joint aspiration and injection techniques |
| Upper Extremity Ultrasound | - Shoulder joint evaluation - Elbow, wrist, and hand structures |
| Lower Extremity Ultrasound | - Hip joint assessment - Knee, ankle, and foot evaluation |
American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology Sample Questions:
1. 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?
A) Flexor hallucis
B) Subtalar joint
C) Flexor digitorum
D) Posterior tibial tendon
2. A 45-year-old man presents to the emergency room for evaluation of right knee pain for the past five days.
He denies a history of trauma and is afebrile on examination. A right knee effusion is noted on exam.
Arthrocentesis is planned and a traditional palpation-guided method is being considered versus an ultrasound-guided technique.
Which of the following is the MOST accurate description of the ultrasound-guided technique in this setting?
A) The ultrasound-guided technique leads to more fluid aspiration among novice physicians.
B) The ultrasound-guided technique results in more pain.
C) The ultrasound-guided technique takes additional time to perform.
D) The ultrasound-guided technique increases the overall success rate in obtaining joint fluid aspirate.
3. For an ultrasound examination, how should the patient, ultrasound machine, and examiner be oriented?
A) The examiner is between the patient and the monitor.
B) The monitor is between the patient and the examiner.
C) The monitor is on the left of the patient for a left-handed examiner.
D) The examiner is closest to the limb of the patient being scanned while facing toward the monitor.
4. What is the MOST appropriate conclusion for the image of this hip?
A) Hip synovitis in longitudinal view
B) Iliopsoas bursitis in longitudinal view
C) Normal longitudinal view of the hip
D) Hip effusion in longitudinal view
5. 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?
A) All appropriate sonographic views of every joint examined
B) Images of the sonographic views with the presence of power Doppler and/or gray-scale synovitis only
C) Representative sonographic image example of power Doppler and gray-scale synovitis supplemented by a detailed report of each examined joint
D) Images of the sonographic views with the presence of power Doppler synovitis only
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: D | Question # 3 Answer: D | Question # 4 Answer: A | Question # 5 Answer: C |
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