Objective To analyze the ultrasonic manifestations of gouty arthritis and its correlation between bone metabolism indexes and clinical manifestations.Methods A total of 180 patients with gouty arthritis were examined by musculoskeletal ultrasound.According to different ultrasonic manifestations

the patients were divided into the non-aggregate group（58 cases）

aggregation group（68 cases） and tophus group（54 cases）.The contents of CTX

OC-N-MID

DKK1 and RANKL in serum were measured.The differences of bone metabolism indexes among the three groups were compared

and the correlation between them and course of disease

serum uric acid level were analyzed.Results Ultrasound showed that there was no punctate strong echo in the non-aggregate group

there was punctuate strong echo and double track sign in the joint of the aggregate group

and tophus or bone erosion in the joint of the tophus group.There were no significant difference of CTX and OC-N-MID among the three groups

but there were statistical difference of DKK1 and RANKL（both P<0.01）.Correlation analysis showed that serum DKK1

RANKL level were positively correlated with course of disease and serum uric acid level in gouty arthritis（all P<0.05）

while serum CTX

OC-N-MID were not correlated with course of disease and serum uric acid level.Conclusion Musculoskeletal ultrasound can detect the specific manifestations of gouty arthritis such as aggregation

double track sign

tophus and bone destruction.With the prolongation of the course of disease

the increase of bone metabolism indexes indicates the aggravation of bone destruction.Musculoskeletal ultrasound combined with bone metabolism indexes can dynamically monitor the joint involvement of patients.