could only do less than 10 scans per week. Lack of time and manpower, lack of expertise, high cost of equipment, and lack of support for training were important obstacles in developing the MSUS service. 18 (64%) responders in our survey tended to agree that MSUS training should be incorporated in the rheumatology training. Conclusions: In conclusion, this is the first survey demonstrating the current state of the use of MSUS in Hong Kong and a huge growth in demand for the service development and formal training in MSUS. A number of challenges in terms of lack of time and manpower, lack of expertise, high cost of equipment, and lack of support for training is evident.Keywords: Rheumatology, musculoskeletal, ultrasound, survey IntroductionMusculoskeletal ultrasound (MSUS) is widely used in rheumatology and recognized as a useful tool in patient management in last two decades. The clinical application of MSUS requires expertise, manpower in terms of doctor time, good quality ultrasound machines, and implementation planning. There are limited data on the present impact of MSUS on rheumatology in Asian countries. The Hong Hong Society of Rheumatology conducted a survey on MSUS in public hospitals and private sector from March to May, 2015. The purpose of this survey was to establish the current state of the use of MSUS and the members' view on the future development Methods: A three-page anonymous questionnaire, divided into three sections (demographics, current state of the MSUS service, and view on future development of MSUS training and services), was sent (either in electronic format or in hardcopy) to 79 members (70 full members and 9 ordinary members) of the Hong Kong Society of Rheumatology. The aim is to inquire about the use of MSUS by rheumatologists, their views on the future development of MSUS training and service in Hong Kong. Results: 28 (35%) out of 79 members responded to the questionnaire (including 25 fellows and 3 trainees working in public hospitals and private sector). 25 responders (89.3%; 25/28) were using MSUS in their daily practice for making diagnoses, guiding interventions or follow-up disease. Although 90% (25/28) of the responders' institutes provided the MSUS service by the Radiology Department, 70% of them got long waiting time, and the Radiology Department did not provide the MSUS service to every joint region. Despite the widespread use of MSUS among rheumatologists, more than 90% of the responders EditorialOpen Access