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)