This chapter provides an in-depth look at how imaging plays a crucial role in diagnosing and managing hand and wrist arthritis. It starts with an introduction to arthritis, covering its clinical impact and how different types of arthritis affect the joints in unique ways. This chapter then explores the various imaging techniques used to evaluate arthritis in the hand and wrist, such as radiographs, ultrasound, MRI, and CT. It also highlights some of the exciting recent advancements in imaging, including dual-energy CT (DECT), high-resolution peripheral quantitative Ct (HR-pQCT), PET-MRI, and the role of Artificial Intelligence (AI), which are improving our ability to detect and understand arthritis. The focus then shifts to the specific radiographic features of different types of arthritis, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, calcium pyrophosphate dihydrate deposition disease (CPPD), and septic arthritis. By focusing mainly on radiographic features, this chapter provides valuable insights into how imaging can help clinicians better understand and manage these conditions.