Imaging of the wrist and hand is a challenging task in the field of musculoskeletal imaging. The anatomy is complex. Knowledge of normal anatomic variants, asymptomatic findings, and other diagnostic pitfalls is crucial for accurate analysis. Variants and pitfalls are commonly found as coincidental findings and may easily be misdiagnosed as relevant abnormalities. The consequences may be over-treatment. Familiarity with common disease processes and their treatment is important.