This study was conducted for 30 patients; 23 (76.6%) females and7 (23.4%) males known to be RA. Their mean age was 38.1 years. Ten healthy adults served as control.This study was planned to assess the value of ultrasonography inthe evaluation of bone destruction and signs of inflammation in themetatarsophalangeal joints of patients with RA, in comparison toconventional radiography and clinical examination.Comparison between CR and US in the detection of erosions inearly RA patients was highly significant. The sensitivity and specificity of CR, in relation to US, in detection of erosions was 57.9% and 95.0% respectively. There was a positive significant correlation between synovial thickening/effusion and Disease Activity Score, also between erosions by US and erosions on CR by Modified Larsen Score.