This study aims to investigate the diagnostic value of 18F-NaF micro PET/CT imaging in mouse models of acute gouty arthritis (AGA). Three male Balb/c mice were designated as the normal control group (Group A), and 18 male Balb/c mice were used to establish the AGA model (Group B). Group A and model groups B (B1h, B3h, B6h, B8h, B12h, B24h) underwent micro PET/CT imaging 40 minutes after injection of the radiotracer. All groups of mice underwent complete blood count, blood uric acid testing, and pathological biopsy of the ankle joint. The results showed that the counts of inflammatory cells in the blood routine of Group B were higher than those of Group A, and there were statistically significant differences between Group B6h and B8h compared to Group A (P < 0.05). 18F-NaF micro PET/CT imaging revealed abnormal tracer accumulation in the right ankle joints of group B, but no bone destruction were observed on CT at the lesion sites; In group A, there was no obvious abnormal gathering of tracer in the left ankle joint. The ratios of maximum standardized uptake value (SUVmax) of the right and left ankle joints (R/LSUVmax) in Group B were higher than those in Group A, and the difference between Group B6h and Group A was statistically significant (P < 0.05). The R/LSUVmax ratios were positively correlated with the counts of white blood cells and neutrophils in the blood routine and microscopic inflammatory cells (R = 0.79, P < 0.01; R = 0.72, P < 0.01; R = 0.79, P < 0.01, respectively). Overall, 18F-NaF micro PET/CT imaging can detect early bone metabolism changes in AGA and visually monitor its dynamic pathophysiological progression.