The aim of this study to show the relation of low vs normal serum vitamin D 25(OH)D (vit D) level in the patient with early onset RA to disease activity. METHODS: 92 RA Patients (72 female and 20 male) with recent-onset RA were assessed clinically and radiographically of both hand x-ray and MSUS assessment, laboratory assessment (RF, anti-CCP, CBC, ESR, and chemistry), disease activity measurement (disease activity HAQ, VAS and DAS-28 score), all data were obtained at the beginning of first

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... e months the disease. Patients are classified into two groups according to the level of vitamin D (normal or low). All cases of hyperparathyroidism, hypothyroidism and the patients who are already received vitamin D or biological therapy are excluded in the study. RESULTS: 92 RA patients (72 females, 20 males) with early onset RA disease less than 6 six months duration. Healthy group age was 38.05±3.49 with normal vitamin D serum level 32.13±13.07. Total patient showed mild decrease in Vit. D than normal value, but there is highly significant differences between DAS-28, HAQ, VAS, MSUS assessment in patient low vs normal Vit. D and inverse relation with disease activity and a significant correlation with disease activity HAQ, and VAS score p<0.05. CONCLUSIONS: There is statistical significant relation with disease activity assessment difference between low vs normal 25(OH)D serum levels in RA early disease activity, So large number of epidemiological studies needed for optimal 25(OH)D concentrations with serial assessment of disease activity in RA patients. KEYWORD: RA, Vit D low vs normal value, MSUS.