New RMSK Content Outline (2026): What Changed and Who It’s For
October 14, 2026
Every RMSK exam starts with the content outline. It’s the document that tells you what the exam covers, how much weight each area carries, and where your study time should go. For 2026, a council of clinicians who perform musculoskeletal ultrasound every day rebuilt the RMSK content outline — the same clinicians whose daily practice gives them the authority to decide what belongs in the outline and what doesn’t. What follows is a plain read of what changed, what the exam now covers, and who the updated outline is for.
What's New in the RMSK Content Outline for 2026?
Quick answer:
- Now reflects all eligible licensures — physicians, Doctors of Chiropractic, Nurse Practitioners, Physician Assistants, Physical Therapists, and Doctors of Naturopathic and Oriental Medicine
- Retired several lower-frequency tasks
- Merged two domains into one: Instrumentation and Data Integration
Musculoskeletal ultrasound isn’t practiced by one kind of clinician anymore, and the 2026 RMSK content outline reflects that. It’s the first version of the outline shaped around the real, day-to-day scope of the full range of MSK healthcare professionals who use ultrasound in practice — not only the specialties traditionally associated with the credential.
Why Was the RMSK Content Outline Updated?
A field survey of practicing clinicians identified tasks that weren’t universally part of real-world MSK ultrasound practice, and identified two domains that functioned as one skill in practice rather than two. The 2026 outline reflects both findings.
- Retired: several lower-frequency tasks, including spine and temporomandibular joint anatomy and procedures, no longer universally part of practice.
- Merged: the former “Physics and Instrumentation” and “Integration of Data” domains are now one domain, Instrumentation and Data Integration — reflecting that equipment optimization and clinical correlation happen together, not separately.
What Does the 2026 RMSK Exam Cover?
The exam covers four domains:
| Domain | Covers | Weight |
| General Sonographic Anatomy | Bones, muscles, tendons, ligaments, bursae, cartilage, joints, and neural structures across the shoulder, elbow, hand and wrist, abdominal and chest wall, hip and pelvis, knee, and foot and ankle. | 20% |
| General Sonographic Pathology | Fractures, cartilage pathology, bone erosion, ligament/tendon/muscle pathologies, joint effusions and instability, cystic structures and masses, nerve pathologies, and crystal deposits, infections, and foreign bodies. | 42% |
| Ultrasound-Guided Interventional Procedures | Aspirations, biopsies, and injections across the same major joint regions. | 17% |
| Instrumentation and Data Integration | Optimizing gray-scale and Doppler technique, evaluating artifacts, transducer selection, safety, and correlating findings into a diagnostic report. | 21% |
Who Is the Updated Outline Built For?
RMSK is open to a broad range of licensed clinicians who perform or authorize musculoskeletal ultrasound studies, including:
- Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO)
- Doctor of Podiatric Medicine (DPM) and Bachelor of Medicine, Bachelor of Surgery (MBBS)
- Doctor of Chiropractic (DC)
- Nurse Practitioner (NP) and Physician Assistant (PA)
- Doctor of Physical Therapy (DPT) and Physical Therapist (PT)
- Doctor of Naturopathic Medicine
- Doctor of Oriental Medicine
Why Does This Matter If You're Not a Physician?
The 2026 outline measures the practice that a Doctor of Naturopathic Medicine, a Doctor of Oriental Medicine, or a Physical Therapist doing real MSK ultrasound work actually has — not just the practice of a single specialty. That matters: an exam blueprint that only reflects one corner of a field sends a quiet message to everyone else that it wasn’t built for them. The 2026 outline sends the opposite message.
What changed in the 2026 RMSK content outline?
Several lower-frequency tasks (including spine and TMJ anatomy/procedures) were retired, and the Physics/Instrumentation and Integration of Data domains were merged into one: Instrumentation and Data Integration.
Who is eligible to take the RMSK exam?
MDs, DOs, DPMs, MBBS-holders, DCs, NPs, PAs, DPTs/PTs, Doctors of Naturopathic Medicine, and Doctors of Oriental Medicine who meet the licensure and clinical case volume requirements.
What are the four RMSK exam domains?
General Sonographic Anatomy (20%), General Sonographic Pathology (42%), Ultrasound-Guided Interventional Procedures (17%), and Instrumentation and Data Integration (21%).
Where can I find the official RMSK content outline?
Inteleos publishes the full, official content outline on the RMSK exam page as a downloadable PDF.
Ready to Review Your Eligibility?
Whatever your licensure path, RMSK eligibility comes down to the same core requirements: a valid, unrestricted license in an eligible category, and a minimum of 150 musculoskeletal ultrasound studies you performed or authorized within the preceding 36 months.
Explore the RMSK exam page for eligibility details and the full content outline.
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