Objective: To compare the clinical assessment of overall inflammatory activity of the shoulder and hip joints being hidden joints and cannot be assessed clinically in patients with rheumatoid arthritis (RA) with ultrasonography (US) and power Doppler ultrasonography (PDUS).Methods:Thirty patients diagnosed as RA in addition to ten normal controls age and sex matched will be subjected to full history taking, thorough clinical evaluation and lab assessment for: .CBC .ESR .CRP .Liver and kidney functions then Ultrasound and power Doppler study of the shoulder and hip joints done by a rheumatologist.Results:High frequency ultrasonography (US) has greatly improved musculoskeletal imaging in rheumatology; several studies have demonstrated that high frequency US is accurate for detecting joint effusion and synovitis compared with magnetic resonance imaging (MRI) and direct arthroscopic visualization. US are more sensitive and reproducible than clinical evaluation in assessing joint inflammation.Power Doppler (PD) US is a new technique of colour Doppler that improves the sensitivity to detect flow from small vessels and low velocity flow at the microvascular level. The PD signal correlates highly with local clinical evaluation of joint inflammatory activity in the knee, metacarpophalangial (MCP) and interphalangeal joints of patients with RA and other inflamatory arthropathies. Recent studies have shown that PD synovial vascularity correlates highly with histologically proved knee pannus and with the degree of synovial vascularisation of the knee and hip.Conclusion:PDUS detects indirect signs of increased vascularization associated with soft tissue musculoskeletal inflammatory and infectious diseases and enthesitis and spondyloarthropathies.