<h3>Background</h3> It is difficult to make a differential diagnosis between seronegative RA and other inflammatory arthropathies. Many patients could be wrong diagnosed followed of expensives treatments. <h3>Objectives</h3> To assess the usefulness of X-rays of hands and feet (X-rays), Ultrasound (US) and Magnetic Resonance Imaging (MRI) to discard false positive diagnosis of seronegative RA from real-world evidence. <h3>Methods</h3> An analysis from medical records of patients with presumptive seronegative RA diagnosis reportedly seronegative for both rheumatoid factor and anti-cyclic citrullinated peptide antibodies and clinical criteria of RA, in the period between July 2016 and ; June of 2017 who were assesed by imagenology (X-rays, US or MRI) in a centre of rheumatoid arthritis to confirm diagnosis or discard it. Laboratory, and imagenology data was retrospectively analysed and multivariate analysis was performed to determinate the usefulness of imagenology. <h3>Results</h3> 360 patients were received in the centre with presumptive diagnosis of RA in the period, mean of age was 58 years, 80,9% females and 19,1% males. X-rays shows only 3,59% of patients with erosions, 38,6% were positive for Ostheoarthritis (OA), and 58,6% of patients without erosions. From patients without erosions, 36% were confirmed for RA and 13,4% for OA by US; on the other hand 37% was confirmed for RA and 20% for OA by MRI. A total of 94 patients (26,1%) had a final diagnosis of seronegative RA, while (261) patients 72,5% were confirmed for Osteoarthrosis,⁵ 1,4% were classified in other arthropaties. <h3>Conclusions</h3> According with our findings the screening by imagenology is a useful tool with low cost to make a differential diagnosis of seronegative RA and other arthropaties. In order to improves outcomes through well-defined treatments and to save high cost treatments for pathologies with more precise diagnoses. <h3>Disclosure of Interest</h3> None declared