Background: Rheumatoid arthritis (RA) is an inflammatory rheumatic disease with progressive course affecting articular and extra-articular structures resulting in pain, disability and mortality. Persistent inflammation leads to erosive joint damage and functional impairment in the vast majority of patients. The onset of disease is not similar in all patients but varies in regard to type, number, and the pattern of joint involvement. The course of disease may be also different according to the presence or absence of several variables including genetic background, frequency of swollen joints, autoantibody in the serum and the severity of inflammatory process. Objective: The aim of this study was to demonstrate the role of Ultrasonography and Power Doppler in diagnosis of activity of rheumatoid arthritis in the hands and wrist joints among different aged population, compared with the laboratory investigations. Patients and Methods: This study was carried out in Radiology department of Ain Shams university hospitals. Twenty-five patients known patients with rheumatoid arthritis suspecting activity will underwent assessment by ultrasonography and power Doppler of both wrist and hand joints. Result: US & PD are highly sensitive and specific in detection of activity of the Rheumatoid Arthritis in correlation to laboratory investigations. So, they can be used as non-invasive methods in detection of RA activity changes in wrist and hand joints. Conclusion: Both ultrasonography and power doppler are good predicators for activity in rheumatoid arthritis patients