Multifocal osteonecrosis associated with human immunodeficiency virus infection.

The osteonecrosis has emerged in the last years as a potentially disabling osteoarticular complication in HIV-infected patients. There is a high prevalence of traditional risk factors for osteonecrosis development in these patients, but they also have factors associated to HIV infection in itself and the high activity antiretroviral therapy. The HIV-associated osteonecrosis often affects the hips, with a trend to bilaterally, but concomitant affection of 3 or more locations (multifocal osteonecrosis) has been infrequently reported. We present the case of a 49-years-old male patient, with long duration HIV infection and antiretroviral therapy, who developed osteonecrosis with concomitant affection of hips, knees, heels and tarsus.