title: Knee osteonecrosis due to lead poisoning: case report and review of the literature.
abstract: BACKGROUND
  Though rare, a relationship between toxic heavy-metal accumulation and bone necrosis exists.
  
  
  METHODS
  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.
authors.affiliation: Department of Orthopaedics, Democritus University of Thrace Medical School, Alexandroupolis, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kazakos
authors.forename: Christos
authors.initials: C
authors.lastname: Chatzipapas
authors.forename: Konstantinos C
authors.initials: KC
authors.lastname: Xarchas
authors.forename: Michael
authors.initials: M
authors.lastname: Mantatzis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tilkeridis
authors.forename: Vasilios
authors.initials: V
authors.lastname: Galanis
authors.forename: Dionisios A
authors.initials: DA
authors.lastname: Verettas
mesh_terms: D000328:Adult; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D007855:Lead Poisoning / Q000150:complications*; D008297:Male; D010020:Osteonecrosis / Q000175:diagnosis* / Q000209:etiology*