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American College of Rheumatology RhMSUS Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Ultrasound-Guided Procedures | - Joint aspiration and injection techniques - Needle guidance and safety principles |
| Foundations of Musculoskeletal Ultrasound | - Ultrasound physics and instrumentation - Image optimization and acquisition techniques |
| Lower Extremity Ultrasound | - Knee, ankle, and foot evaluation - Hip joint assessment |
| Upper Extremity Ultrasound | - Elbow, wrist, and hand structures - Shoulder joint evaluation |
| Inflammatory and Degenerative Pathology | - Synovitis, effusions, and erosions - Tendinopathy and enthesitis patterns |
American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology Sample Questions:
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. D
- B. A
- C. C
- D. B
For which of the following clinical scenarios is it appropriate for a practitioner to perform musculoskeletal ultrasound?
- A. A patient with psoriasis and posterior heel pain
- B. A 50-year-old woman with pain between the third and fourth metatarsals
- C. A 40-year-old man with a snapping sensation in his groin with hip flexion and external rotation
- D. A patient who has pain and numbness over the lateral calf
A practitioner obtains the following ultrasound image of a patient with a positive rheumatoid factor and normal ESR, CRP, and hand X-rays.
Which of the following options would be an evidence-based statement during a discussion of the management plan?
- A. A positive Doppler signal is a predictor of future joint damage.
- B. Low-grade synovial hyperemia is found in most patients in clinical remission from rheumatoid arthritis.
- C. Severe (high-grade) synovial hyperemia, but not mild (low-grade) hyperemia, would be an indication to change therapy.
- D. Hyperemia is suggestive of a septic joint and requires further diagnostic testing.
The image below shows the injection of the dorsal wrist region in a patient with rheumatoid arthritis. The needle is indicated by the arrows. Considering the ultrasound findings, which of the following is MOST appropriate in completing the injection?
- A. Both the radiocarpal and midcarpal recesses should be targeted.
- B. The radiocarpal recess should be the primary target.
- C. The fourth compartment ten synovium should be targeted.
- D. The midcarpal recess should be the primary target.
Which is the MAIN pathologic finding shown by this ultrasound picture in a patient with psoriatic arthritis?
- A. Proximal interphalangeal osteophytes
- B. Proximal interphalangeal synovitis
- C. Flexor tenosynovitis
- D. Flexor tendon rupture with reparative hyperemia
