Background: Though rare, a relationship between toxic heavy-metal accumulation and bone necrosis exists.
Case report: A 28-year-old man suffered from chronic bilateral knee pain accompanied by muscle fibrillations and night cramps. On examiniation he presented tenderness and mild quadriceps muscle atrophy, but unaffected range of movement, sensation, and tendon reflexes and no effuision. He also complained of blurred vision, lethargy, and tremor.
Conclusions: On the basis of these data it appeared that these infarcts were attributable to lead poisoning. This situation has not been described in the knee region, but finrther clarification of a possible causal relationship between toxic trace element concentration and idiopathic bone necrosis appears necessary.