This study included fifty patients (39 females and 11 males) with rheumatoid arthritis. They were subjected to power doppler ultrasound study and enhanced MRI examination of the clinically dominant hand joints (50 wrist and 200 MCP joints).Mean age was 45.3 yr and mean disease duration was 6.2 yr. PDUS score of synovitis was correlated and compared with MRI OMERACT score, other signs of inflammation and bone destruction were also evaluated. Our results showed that both modalities are comparable and closely related in the assessment of inflammatory process of hand and wrist joints in RA.