Abstract: Objective To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in the pathogenesis of rheumatoid arthritis. Methods Total 30 patients (54 wrist joints) of rheumatoid arthritis treated with wrist pain were selected from January, 2015 to November, 2016. The patients were treated with the same time. There were 23 healthy patients (46 wrist joints) in the hospital. The color Doppler ultrasonography was used to detect the synovial thickness of the wrist joint in the two groups. The correlation between DAS28, EST, CRP and RF was analyzed by ultrasonography (CEUS) in the wrist of the observation group. Results ①There were 51 (94.44%), 33 cases (61.11%) of joint effusion, 29 (53.73%) of bone lesions and 46 wrist There were 3 (6.52%), synovial fluid (7.14%) and joint erosion (2.17%), and the difference was statistically significant (P<0.05). The mean synovial thickness of the observation group was (3.23±1.27) mm, and the mean synovial thickness was (1.37±0.65) mm in the group. The difference was statistically significant (t=15.731, P<0.001). ②In the observation group, 52 cases of synovial thickening were detected. The detection rate was 82.35%, among which 17 were Grade Ⅰ, 18 were Grade Ⅱ and 7 were Grade Ⅲ. The detection rate was 33.33% and the signal intensity was grade Ⅰ, and the difference was statistically significant (P<0.001). ③There was no correlation with RF and Anti-CCP. Ultrasound contrast TIC quantitative grading was positively correlated with synovial thickness and CEUS perfusion grade. Conclusion Ultrasonography can clearly show the changes of synovial membrane in the wrist, and quantitatively analyze the perfusion of synovial fluid. It is positively correlated with serological parameters and disease activity. In the early diagnosis of rheumatoid arthritis wrist activity has a high clinical value.