OBJECTIVE To determine normal anatomy of hand distal interphalangeal joints at ultrasonography, and to compare sonographic and anatomic findings. METHODS Right hands of three embalmed cadavers and dominant hands of 10 asymptomatic volunteers were evaluated. Distal interphalangeal joints were scanned longitudinally and transversely with a high-frequency linear-array transducer. Sonographic appearances of intra-articular and periarticular structures were analysed in consensus by two musculoskeletal radiologists. Cadaveric dissection provided anatomic comparisons. RESULTS Sagittal and transverse sonographic images enabled good analysis of the extensor tendon, the deep flexor tendon, and the palmar plate. The radial and ulnar collateral ligaments were identified on all coronal scans. Direct visualization of the dorsal triangular structure and of the middle phalanx head's cartilage was possible on longitudinal scans. The dorsal and palmar synovial recesses were better recognized when a small amount of fluid was present. CONCLUSIONS Ultrasonography with a high-frequency linear-array transducer provides detailed anatomical information about intra-articular and periarticular structures of the hand distal interphalangeal joints.