Multifocal osteonecrosis predominantly affecting the knees secondary to chronic alcohol ingestion: A case report and review.

We present a case of multifocal osteonecrosis secondary to alcohol ingestion in a middle aged lady, after the exclusion of other causal factors. It presented initially with knee pain and subsequently necessitated arthroplasty; other areas became more problematic. This condition is rare and we present a literature review that reveals that after steroids the suspected link to alcohol is not so obvious. A high index of suspicion is required and treatment remains expectant and symptomatic. The role of screening is also discussed.