An atypical site of osteonecrosis in a patient with systemic lupus erythematosus

We describe a patient with systemic lupus erythematosus who developed osteonecrosis. The case is unusual because the osteonecrosis occurred in an unusual location, in the distal tibia. The patient had earlier developed recurrent pyarthrosis, and biopsy and culture were required to exclude osteomyelitis.