Tender joint count (TJC) is included in Composite Disease Activity Scores (CDAS) (DAS28/CDAI/SDAI). The impact of having predominantly tender joints was explored by use of the Tender‐Swollen Joint count Difference (TSJD). Ultrasound (US) provides a measure of joint inflammation. The present study aimed to explore the cross‐sectional and longitudinal associations between TSJD and a spectrum of outcome measures including US scores in patients with established rheumatoid arthritis (RA) during follow‐up on bDMARD treatment. To read the full article, log in using your NHS OpenAthens details.