Hyperuricemia (HUA) is a disorder of purine metabolism, with an increasing incidence. Long⁃term HUA can easily induce gout, and it can easily affect the kidneys and cardiovascular system. Musculoskeletal ultrasound (MSKUS) refers to the use of conventional ultrasound diagnostic equipment and special high⁃frequency ultrasound probes to confirm the diagnosis of human muscles, soft tissues and skeletal diseases. MSKUS in the diagnosis and observation of gouty arthritis HUA MSKUS can more effectively detect the intra⁃articular double⁃track sign, aggregates, tophi and bone erosion that are easy to ignore, compared with other inspection methods, and has a certain degree in the diagnosis of gouty arthritis. Therefore, the use of MSKUS can comprehensively evaluate the condition of HUA patients with gout. Besides, the characteristic changes of ultrasound in asymptomatic HUA patients all occur at MPT1. Therefore, MSKUS can screen the key parts of MPT1 in asymptomatic HUA patients, which can detect and treat more promptly and better prevent the occurrence and development of gout. MSKUS can be used to relieve the disappearance of the dual⁃track sign in the joint during the follow⁃up treatment of gout patients, which can better evaluate its efficacy. MSKUS has many advantages such as high sensitivity, repeatable operation, simple use, etc. Therefore, it has high application value in the diagnosis and treatment of HUA and gout patients.