: Objective: Explore musculoskeletal ultrasound to evaluate the effects of primary Sjogren’s syndrome (PSS) arthritis and the immune biochemical characteristics of patients. Methods: All 81 patients with PSS were admitted between April 2019 and April 2020. Musculoskeletal ultrasound and immuno-biochemical tests were performed to analyze the accuracy, specificity, and sensitivity of musculoskeletal ultrasound. According to the diagnosis results, PSS patients were classified Divided into arthritis group (n=65) and non-arthritis group (n=16). The ultrasound examination results, immunobiochemical indexes, and age of the two groups were compared. Results: Among the 81 patients with PSS, 65 were diagnosed with arthritis at a later stage, and the prevalence was 80.25% (65/81). The accuracy of musculoskeletal ultrasound examination was 96.30%, the sensitivity was 96.92%, the specificity was 93.75, and the AUC was 0.953, which has high predictive accuracy. In the arthritis group, bone erosion, osteophytes, tendon tenosynovitis, joint space stenosis, synovitis, joint effusion rate and blood flow signal score were higher than those of non-arthritis patients (P<0.05), and the thickness of synovial membrane was thicker than that of non-arthritis Those with inflammation (P<0.05). From the perspective of immunobiochemical indicators, there is no statistical difference between the two groups in IgA and IgM indicators (P>0.05), while the age, RF, IgG, ESR, and CRP of the arthritis group are higher than those of the non-arthritis group (P<0.05); The prevalence of PSS arthritis is negatively correlated with age, RF, IgG, ESR, CRP, synovial thickness, blood flow signal, SSDAI score, and is associated with bone erosion, osteophytes, tendon tenosynovitis, joint space stenosis, synovitis, There is a positive correlation with joint effusion. Conclusion: Musculoskeletal ultrasound has high specificity and sensitivity in the assessment of PSS joints. In conjunction with immuno-biochemical testing, it is found that patients with PSS arthritis have hyperimmune inflammation and hyperglobulinemia, which are manifested as RF, IgG, ESR, CRP index increased.