الفهرس 
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Abstract
Over the last decade, the usage of musculoskeletal US in the diagnosis and follow-up of the disease activity in RA has improved dramatically. Different scoring systems have been tested and developed for this purpose using GS and PDUS. Many of these scores have dropped the ankle joint from evaluation and agreement on evaluation parameters is poor among those which include the ankle.
In our study, tenosynovitis was found more frequently than synovitis.
A positive relation was found between erosion and disease duration. Bilateral ankle involvement was observed with longer disease duration. There is considerable controversy about symmetry in RA.
It was clear in our study that there was an obvious relation between ankle involvement and disease duration. Tenosynovitis was found in our study to be an early sign followed by synovitis and finally erosion. Our study revealed an association between DAS28-ESR score and involvement of the ankle joint or tendons, which was more significant for tenosynovitis.
It is plausible that our study had a number of limitations. One of them is exclusion of Tendon Achilles and plantar fascia evaluation. Another pitfall is not using the Erosion score used by Ohrndorf et al, and instead we used the (0-1) binary score.
Conclusion
It can be stated that ankle evaluation by US should be considered more in RA assessment, and further studies should be done to uncover the under-etsimation of ankle involvement in RA patients.