ationale and Objectives:To evaluate the role of musculoskeletal ultrasound(MSUS) in the grading ofrheumatoid arthritis (RA) wrist and hand joints and correlate it with clinical, laboratory,and radiological data.Material and MethodsA cross-sectional study recruited 50 patients in a tertiary care hospital. RA activity wasassessed by DAS28. MSUS dorsal longitudinal scan was performed on the wrists,MCPs, and PIPS joints using high frequency (18 MHZ) linear transducer. 100 wrists inthree different views, 500 MCPs, 500 PIPs were evaluated using the grey scaleultrasound (GSUS) and power Doppler ultrasound (PDUS) semiquantitative scale andscores ranging from 0-3. The results were correlated with clinical, laboratory andradiological data. All patients’ wrist and hand joints X-rays were evaluated using theLarsen score.ResultsThe mean age of the patients (49 females and one male) was 44.58 ± 10.07 years,and their mean disease duration was 16.26±1.07 years. The mean DAS28 was5.19±0.95. 97.5% of joints had grade I Larsen score, 11.07% of the joints haderosions, 9.2% of the joints had effusions, 23.8% of the joints had synovial thickening,11.9% of the joints showed PD signals and 3.5% of the joints were accompanied withtenosynovitis. Significant relations (p<0.05) found among DAS28 and (PD signals,synovial thickening, tenosynovitis, effusion, and Larsen score). A non-significantrelation (p>0.05) among DAS28 and erosions detected by MSUS and X-ray. ConclusionMSUS is powerful in the detection of early RA regarding synovitis, joint effusion,tenosynovitis,and bone erosions, which were correlated with clinical and laboratoryparameters