The attempt to measure and quantify changes related to inflammation and structural damage lesions represents one of the most interesting topics in the field of musculoskeletal ultrasound in rheumatology. Different scoring systems have been used over the recent years to measure inflammation and structural damage lesions in patients affected by inflammatory and degenerative rheumatic diseases. In the last years quantitative and semiquantitative methods in several studies have been applied, with promising results. In the present review we reported the main studies about this topic. However, more studies are needed to address some technical issues and quantify ultrasonography-detected abnormalities. © 2011 Bentham Science Publishers Ltd.