The bones of the hand and wrist provide the body with support and flexibility to manipulate objects in many different ways. Each hand contains 27 distinct bones that give the hand an incredible range and precision of movement. The forearm’s ulna and radius support the many muscles that manipulate the bones of the hand and wrist. Although the anatomy of the hand and wrist are complex and the pathologic conditions encountered are diverse, many of the disease processes are localized, and in many situations, the clinical question is specific and limited. Because of this, ultrasound has always been an attractive imaging modality for evaluation of hand and wrist problems. Specific situations in which ultrasound offers definite benefits include evaluation of tendon inflammation and rupture, evaluation of palpable masses or suspected occult masses, and evaluation of suspected foreign bodies. Hand and wrist injuries are also common in athletes and can affect articular structures (ligaments, joint surfaces etc), peri-articular tendons, muscles and nerves. These injuries can be acute or chronic. Acute injuries follow sudden traumatic events such as falls or joint sprains. Chronic lesions can be the result of local repetitive microtrauma or the sequelae of an acute injury.