Objective: Rheumatoid arthritis (RA) is the most common inflammatory joint disease. Many studies have shown that erosions and synovitis can be picked up at an early stage on ultrasonography (US) when X-rays appear normal. Ultrasonography exams in inflammatory arthritis helps in determining objective evidence of inflammatory arthritis- synovitis, erosions, effusions and also help in monitoring therapy in established RA patients. Materials and methods: Ninety patients aged over 18 years, who were diagnosed with RA (according to 2010 ACR criteria) of less than two years duration, were included in the study prospectively. Baseline data, disease activity score of 28 joints (DAS 28 score), complete clinical evaluation and laboratory investigations were registered. Conventional radiographs of both hands were taken in posteroanterior views. A power Doppler US was performed on all metacarpophalangeal (MCP) joints and proximal interphalangeal (PIP) joints of both hands. Results: Out of the 90 patients, 84 had positive findings on US and only 13 subjects had positive radiographic findings. The second MCP was the most common joint involved on US. The mean cumulative flow signal (CFS) score was 4.15±5.12. The relation between CFS and DAS 28 scores was highly significant, with p value <0.01. Conclusion: Ultrasonography can detect changes in joints at an earlier stage than radiographs. Both grey scale and power Doppler US have a role in detecting synovitis and erosions.