This study was carried out to evaluate sonographically the prevalence of early joint involvement in HCV patients without any rheumatic symptoms compared to control healthy subjects without any markers of HCV or HBV infection. The study included fifty patients with hepatitis C virus examined clinically and radiological by ultrasonography for the knee, hip and shoulder joints. None of these patients had previously suffered from musculoskeletal symptoms or any infection in addition no one was under any medication at time of examination. They were compared to 20 normal healthy control people with matching age and sex without HCV or other autoimmune or chronic diseases were. Ultrasonographic alteration were detected in 96 % of the HCV patients with highly significant difference in comparison to controls (p<0.000). Slight inflammatory changes were found in all the joints examined more than the moderate or severe changes. The knee and shoulder joints were involved in 74% of HCV patients for each and the hip in 68%. There were higher prevalence and highly significant differences as regard the knee synovial thickening and effusion, hip effusion, trochanteric bursitis, supraspinatus tendon fluid collection and acromioclavicular joint effusion in comparison to the control. The study demonstrated the presence of joint changes in near all the asymptomatic patients with HCV with the prevalence of slight inflammatory alteration that can be explained by the presence of sub-clinical synovitis as well as the presence of significant changes in some of periarticular structures.