Abstract： Objective:To explore the ultrasonographic characteristics of asymptomatic hyperuricemia（HUA）and gout knee joint lesions in naval officers and sailors，so as to improve the HUA prevention and treatment in them.Methods:A total of 168 HUA cases were selected from the naval officers and sailors admitted to the Beidaihe Rehabilitation and Recuperation Center of Joint Logistic Support Force from January 2016 to December 2021，of whom 22 cases were diagnosed as gout（gout group），and the other 146 cases were asymptomatic hyperuricemia（HUA group）. Another 58 cases with normal blood uric acid who were admitted to the center during the same period were selected as the control group. All three groups underwent high-frequency and color doppler musculoskeletal ultrasonography on knee joints，ankle joints，first metatarsophalangeal joints，and the surrounding soft tissues. The correlations between serum uric acid level and articular cartilage lesions in the three groups were analyzed and compared.Results:Compared with the HUA group，the gout group had significantly higher serum uric acid level and body mass index（BMI）（ P<0.05），and a significant higher detection rate of sonographic features，such as synovial hyperplasia，synovitis，synovial sac effusion，double track sign，bone erosion，and gout stone（ P<0.05）；besides，the mean cartilage thickness and maximum gout stone diameter in the gout group were significantly increased（ P<0.05）. Logistic regression analysis showed that the double track sign and gout stone in the HUA group were the influencing factors of the incidence of HUA in naval officers and sailors（ P<0.05 or P<0.01）. In the gout group，six typical sonographic features of synovial hyperplasia，synovitis，synovial sac effusion，double track sign，bone erosion，and gout stone，as well as mean cartilage thickness and maximum gout stone diameter，were the risk factors of gout in naval officers and sailors（ P<0.05 or P<0.01）. Conclusion:Musculoskeletal ultrasonography can detect the uric acid salt crystallization and the changes of joint structure in early stage of HUA，thus providing basis for early diagnosis of HUA and gout.