Ultrasound is an extremely useful and versatile method of assessing soft tissue abnormality in rheumatological conditions. It is best performed as an extension of clinical examination. Ultrasound has the advantage of not only being able to demonstrate abnormalities but also allows transducer compression of those abnormalities to see if it reproduces the patient's characteristic symptoms. It is likely to find even greater use in the clinical setting over future years. In the near future skeletal ultrasound should develop into an essential tool for the extension of physical examination in rheumatology practise. It hopefully will become as vital to a rheumatologist as echocardiography is to a cardiologist. This will however require clinicians to be prepared to undergo sufficient training in order to avoid diagnostic errors. Probably it will only be at that time, when skeletal ultrasound has become a fundamental part of rheumatological diagnosis, that its full potential will be realized.