Objective To investigate the diagnostic value of ultrasonic and imaging features of (RA) wrist joint lesions in rheumatoid arthritis. Methods 48 patients with RA and wrist joint lesion in our hospital from February 2016 to June 2018 were selected in the study. The wrist, the first to fifth metacarpophalangeal joints (MCP) and the 2nd to 5th proximal interphalangeal joint (PIP) were examined with ultrasonic diagnostic instrument and CT scanner, the synovial thickness, joint cavity effusion and bone destruction were analyzed. Results 1206 joints were examined in 48 patients, including 110 wrist joints, 548 MCP joints, and 548 PIP joints. Ultrasound imaging features: 1. wrist synovitis showed low echo in the joint cavity, could not be displaced or compressed, there was blood flow signal. 2. wrist joint effusion under ultrasound showed joint space increase, banded shape, stripshaped anechoic area, uneven distribution, can be displaced or compressed, no Doppler blood flow signal. 3. wrist bone erosion under the ultrasound showed disruption of cortical bone continuity or "crater-like" defect, "worm-like" changed, the osteoporosis and joint space stenosis signs were visible by CT, there was significant bone erosion changes in the right wrist joint right scaphoid and distal radius joint surface; the detection rate of bone erosion and early wrist lesion by ultrasound was higher than that by CT (P<0.05). There was no significant difference in the detection rate of synovitis, joint effusion, tenosynovitis by the two methods (P>0.05). Conclusion When patients with RA appear arthropathy, the degree of synovial thickness, joint effusion and bone destruction can be detected by ultrasound diagnosis. The use of CT examination has certain diagnostic value, but it is not as good as ultrasound diagnosis in evaluating bone erosion.