Bone scintigraphy is the most common and oldest nuclear medicine technique being used to evaluate the musculoskeletal system, including the hands and wrists. Because of their widespread availability and better resolution over the last few decades, advanced imaging choices such as computed tomography (CT) and magnetic resonance imaging have replaced many nuclear medicine techniques as first line investigations. However, triphasic bone scintigraphy remains the investigation of choice in a few unique indications such as reflex sympathetic dystrophy. Recently, single photon emission computed tomography/CT and positron-emission tomography/CT have revolutionized nuclear medicine imaging because of three-dimensional imaging ability and better anatomical correlation that enable accurate interpretation of equivocal findings. Increasing availability of advanced hybrid scanners and invention of new tracers will enable nuclear medicine techniques to regain the lost turf in musculoskeletal imaging.