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. 2019 Jan 15;20:23. doi: 10.1186/s12891-019-2401-y

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© The Author(s). 2019

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Fig. 2 — A 42-year-old male case of multifocal osteonecrosis (ON). a This is a bone scintigraphy performed in a 42-year-old male patient with abnormal photon-defects in both femoral heads (long arrows). Also abnormal hot uptakes were also observed in the left humeral head (white arrow), both distal femoral (short arrows) and proximal tibial regions (arrowheads), suggesting that AVN is suspected. b Pelvis anteroposterior view (AP) shows radiolucency and surrounding sclerosis of both femoral heads (arrows). c Coronal T1-weighted image shows large areas of low signal intensity demonstrated typical band-like pattern of ON involving both femoral heads (arrows). d Both knee AP views show ill-defined lucency and sclerosis with cyst like appearance of both distal femur and proximal tibia. e Coronal T1-weighted image shows multiple geographic lesions with peripheral low signal intensity of rim involving both distal femur and proximal tibia. f Simple radiographs show more advanced degree of ON with subchondral fracture and mild osteoarthritic change involving left humeral head (arrow)