INTRODUCTION: The objective of this investigation was to reveal abnormal musculoskeletal ultrasonographic (US) findings in the hand and wrist joints of systemic sclerosis (SSc) patients compared to healthy controls and to determine the severity of synovitis and tenosynovitis, as well as to disclose the demographic, clinical, and serologic characteristics of patients with SSc with synovitis. METHODS: The current study is a cross-sectional study comparing 50 SSc patients and 50 healthy controls between February and September 2023. Metacarpophalangeal (MCP), proximal interphalangeal (PIP), distal interphalangeal (DIP), and wrist joints were evaluated with US. RESULTS: Synovitis (24 (48%) vs 6 (12%), CONCLUSIONS: Synovitis, tenosynovitis, and synovial hypertrophy seem to be quite common in SSc patients with or without arthralgia. Patients with synovitis are older, and acute phase markers may be higher in these patients.