Purpose of Review The increased use of musculoskeletal ultrasound (MSKUS) in clinical practice warrants achieving competency earlier in physiatrists’ careers. Physical Medicine and Rehabilitation (PM&R) residency programs have started incorporating formal MSKUS training in their curricula; however, significant heterogeneity remains in MSKUS education. Recent Findings Numerous barriers contribute to the lack of consensus for MSKUS training during residency, but the COVID-19 pandemic severely disrupted in-person learning. As an adjunct or alternative to in-person learning, teleguided technology is being utilized. Summary This curriculum demonstrates the role of a hybrid MSKUS training with interinstitutional collaboration. Twenty PM&R learners, from two institutions, were divided into a fundamental or advanced track. Virtual didactic sessions alternated weekly with hands-on ultrasonographic scanning sessions. Following a 12-month longitudinal curriculum, an end-of-year practical examination was used for competency assessment, in addition to a survey assessing resident perceptions and feedback. To our knowledge, this is the first collaborative and hybrid MSKUS curriculum for PM&R learners that can be easily reproduced at most training institutions and circumvent some of the barriers amplified by the COVID-19 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s40141-023-00380-z.

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Background Acromioclavicular (AC) joint cysts are relatively rare. There are two distinct etiologies of AC cysts. Type 1 is isolated to the AC joint, while type 2, is related to a tear or rupture of the rotator cuff (RC). The disease is usually a rare result of advanced AC joint arthritis or RC-tear arthropathy. Patients may present with signs and symptoms of RC impingement and tear. Conservative management may be used initially in asymptomatic individuals who are also not concerned with cosmesis. Aspiration and steroid injection of the cyst has been reported as one method of non-surgical management of these lesions, however, there is a high rate of recurrence. Case Presentation We report a case of A 72-year-old right-handed female with past medical history of type two diabetes mellitus, chronic smoking, and a prior right RC repair with distal clavicle resection who presented with an AC joint cyst complicated by a draining fistula as a result of cyst aspiration and steroid injection. Due to the persistent drainage of the cyst and concern for infection, the patient was treated with a staged reverse shoulder arthroplasty given the setting of an irreparable rotator cuff tear and end-stage cuff-tear arthropathy. Conclusion This case demonstrates an important complication of persistent draining fistula resulting from AC joint cyst aspiration and steroid injection in the setting of advanced RC-tear arthropathy. In immunocompromised patients, staged reverse shoulder arthroplasty should be considered for treatment of these draining fistulas especially when the concern for periprosthetic infection is high.