Objective: A cross section study was designed to analyze the value of ultrasound (US) findings in sacroiliac joint compared with physical examination in patients with spondyloarthropathy (SPA) with or without inflammatory back pain. Methods: 30 patients with SpA; 15 with ankylosing spondylitis (AS) and 15 with psoriatic arthritis (PsA) were classified according to European Spondylarthropathy Study Group criteria (ESSG), and 30 age and sex matched healthy individuals were taken as a control group. All patients and controls had clinical examination and US imaging of sacroiliac joint (SIJ). Results: Ganslens’ and Patricks’ tests were positive in 90% of the SpA patients. US showed presence of vascularity in 14 (46.7%) SpA. Unfortunately we did not find any effusion in the SIJ. Ganslens’ test showed equal sensitivity to Patricks’ test in detection of sacroiliitis as proved by US (92.9%) which is the highest sensitivity among the other SIJ clinical tests, while each one of them showed the least specificity (12.5%).When we combined more than one clinical test of SIJ to improve their sensitivity in detection of sacroiliitis, as proved by US finding of vascularity, we found that combined 2, 3, and 4 clinical tests showed sensitivity (100%, 78.6%, 50%) respectively and specificity (12.5%, 18.8%, 37.5%) respectively. Conclusion: US is useful in the assessment of SIJ in SpA patients, resulting in images that are fast and inexpensive and may locate, complementing the physical examination, the origin of inflammatory back pain.