Background: Rheumatoid arthritis (RA) is a common systemic autoimmune disease influencing 0.5–1% of the population. The RA diagnosis is based essentially on clinical and biological parameters, even though the novel American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) sortingstandardscomprise MRI and ultra-sound (US) as extra tools to evaluatethe objective joint connection. Our study to evaluate the values of Ultra-sound 7 scores in the diagnosis of sub-clinical synovitis in the early RA- Cases and its correlation with the disease activity score (DAS28). Results: A significant positive, but moderate association was found between DAS28 score and GSUS synovitis total score (r = 0.52, p < 0.001) and fair positive association with power Doppler synovitis total score (r = 0.44, p < 0.001). DAS28 was not connected to total erosion score (r = 0.045, p = 0.754). Conclusion: Ultrasound 7 is simple and practical scoring system and we recommend it for usage in the diagnosis of sub-clinical synovitis in the early RA-cases.