This review discusses our experience with conventional radiography and advanced imaging techniques in the evaluation of diverse soft tissue, skeletal and joint abnormalities frequently observed in patients with both the primary and secondary forms of hypertrophic osteoarthropathy. The manifestations include finger clubbing, elephant feet, cutis verticis gyrata, synovial effusion, periostosis, tuftal hypertrophy and acro-osteolysis. Its coexistence with other skeletal and joint diseases and its imaging differential diagnosis are also reviewed.