Point of care ultrasound (versus ultrasound done at a radiology centre) is becoming more commonly seen in rheumatology offices.  It is still not considered standard of practice for rheumatologists, as those rheumatologists who offer ultrasound should have undertaken extra training to ensure they are competent and able to accurately interpret the images.  Ultrasound is not necessarily needed for all patients.  For most individuals, a good physical exam provides the needed information to make a good plan for managing your arthritis.  In some cases, it can be helpful, which is when a rheumatologist who does not do ultrasound themselves will either ask their colleague to perform the test, or have the patient assessed at a radiology centre.