Objective: The present study was performed to compare effectiveness of Doppler US and MRI of joints of the hand, in the assessment of synovial inflammation and erosions, and to try to correlate these findings with disease activity in RA patients.Methods: Thirty adult RA patients with a mean age of 42.07 years and a mean disease duration of 7.45 years, were subjected to: full history taking, full clinical examination, laboratory investigations to detect disease activity, plain x-ray for the hands, Doppler US and MRI for the clinically dominant hand, with ten healthy adults age and sex matched served as a control group. Results: US synovial inflammation was detected in 42 joints (20.8%) and in 52 joints (25.7%) by MRI with moderate (agreement) similarity of both techniques, tenosynovitis in 15/120 tendons (12.5%) by US and in 16/120 tendons (13.3%) by MRI with excellent similarity. Signs of bone destruction were detected in 34/202 joints (16.8%) by US and in 60/202 joints (29.7%) by MRI with moderate similarity of both techniques. Increased vascularity was detected in 21 joints (10.4%) by Doppler US. No abnormalities were detected in the control group. Conclusion: We concluded that the US findings can be comparable to those of MRI which is known to be the gold standard in the detection of inflammatory changes in RA joints, and that Power Doppler US is useful in the detection of vascularization of the synovial membrane and assessment of the activity in the joints.