Background: Chronic inflammatory illnesses with unknown causes known as inflammatory bowel diseases (IBD) involve ulcerative colitis (UC), Crohn's disease (CD), as well as atypical colitis. Objective: This study aimed to detect the role of musculoskeletal ultrasound in screening of subclinical involvement and degree of joint affection in hand and wrist joints in IBD patients with and without musculoskeletal manifestations. Subjects and methods: This was Cross-sectional research performed on seventy-five subjects, involving fifty cases that had been previously diagnosed with IBD through colonoscopy, and biopsy examined histopathologically at Tanta University Hospitals. They were compared with 25 healthy individuals during the period from December 2022 to January 2024. Results: This study detected synovitis in 33 subjects (44%), including 20 patients with UC, 6 patients with CD, and 7 in the control group. All cases of synovitis were without a power Doppler signal, except for two patients in the UC group who exhibited a grade one Doppler signal. In terms of the number of affected joints, synovitis was detected in 68 joints. The most commonly affected joint with synovitis was the left second metacarpophalangeal (MCP) joint, followed by the left and right wrists. Conclusion:  Musculoskeletal ultrasound (MSUS) can detect mild to moderate joint involvement in IBD patients, indicating its value as an accessible imaging tool for assessing joint involvement. It is recommended to include MSUS in IBD patient evaluations, especially those with elevated inflammatory markers, as it provides additional information.