BACKGROUND Ultrasonography provides information regarding synovial membrane proliferation and its vascularization. The AIM of our study was to evaluate the role of gray scale and power Doppler ultrasonography in assessing early rheumatoid arthritis by analyzing the scores determined by the evaluation of synovial proliferation, joint effusion, erosion or soft tissue swelling. METHODS The study was prospective comprising 34 patients (31 female, 3 men), mean age 45.68 years, with clinical changes and biochemical early rheumatoid arthritis. Bilateral wrist, II-V metacarpophalangeal, and proximal interphalangeal joints were evaluated by dorsal and palmar scans. RESULTS The mean duration from the onset of symptoms was 3.46 months. Based on the clinical, biochemical and US scores the patients from our study presented early stages of RA. Also, statistically significant correlations were observed between the time elapsed from the onset, the changes highlighted by ultrasound and the stage of the disease (stage 0 or 1). CONCLUSIONS Our study confirms that US evaluation of changes in the joints of the hand offers useful information for staging the diagnosis of RA.