The rising prevalence of hyperuricemia, influenced by changes in diet, underscores the importance of conducting population-based epidemiological research, especially in regions lacking sufficient data. In addition to the well-documented complications of hyperuricemia on renal and articular aspects, elevated serum uric acid levels are identified as a significant risk factor for cardiovascular diseases, strokes, joint manifestations, and renal failure. Prolonged asymptomatic hyperuricemia may lead to vascular and articular lesions. This condition is characterized by an increase in plasma uric acid levels without clinical signs of gout, posing a therapeutic challenge due to uncertainties surrounding the risk-benefit ratio of urate-lowering treatments [ULTs]. While the need to treat asymptomatic hyperuricemia is still a topic of debate, the detection of urate deposits through imaging, particularly osteoarticular ultrasound, emerges as a crucial indicator. Various imaging techniques, such as synovial fluid microscopy, computed tomography [CT], dualenergy computed tomography [DECT], and osteoarticular ultrasound, assist in identifying uric acid crystal deposits, with DECT being an innovative method. Osteoarticular ultrasound provides a unique opportunity to better characterize individuals with hyperuricemia and gout, influencing the determination of therapeutic goals and clinical directions. Specific signs like "double contour" and tophi, assessed by color Doppler, contribute to diagnostic precision. Osteoarticular ultrasound serves as a potentially significant tool for diagnosing, assessing, and monitoring gout pathology, offering the possibility to decide on and evaluate treatment effectiveness. Despite its utility, the reproducibility of osteoarticular ultrasound requires thorough investigation. This tool proves crucial in the nuanced management of asymptomatic hyperuricemia, providing valuable insights into the patterns of urate crystal deposition and guiding therapeutic interventions.