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Data on patient demographics, including age, sex, body mass index (BMI), history of corticosteroid intake, alcohol abuse, smoking, and symptomatic joints, were collected from their medical records. All patients underwent WB-MRI and WB-BS before surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The agreement in the detection of ON by WB-MRI vs the uptake lesions by WB-BS in the hip joints was moderate (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.584), while that in other joints was low (<jats:italic>\u03ba<\/jats:italic>\u2009&lt;\u20090.40). Among the 152 joints with ON detected by WB-MRI, 92 joints (60.5%) were symptomatic, and 60 joints (39.5%) were asymptomatic. Twelve out of the 46 (26.0%) patients had multifocal (three or more distinct anatomical sites) ON. Nonetheless, while WB-BS detected symptomatic ON detected by WB-MRI as uptake lesions in 82.6% (76\/92) of the joints, asymptomatic ON detected by WB-MRI was detected as uptake lesions in 21.7% (13\/60) of the joints. All patients with multifocal ON had a history of steroid therapy, which was significantly higher than that in patients with oligofocal ON (<jats:italic>P<\/jats:italic>\u00a0=\u20090.035). The patients with a hematologic disease had multifocal ON at a higher rate (<jats:italic>P<\/jats:italic>\u00a0=\u20090.015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It might be difficult for WB-BS to detect the asymptomatic ON detected by WB-MRI compared to symptomatic ON. Considering the cost, examination time, and radiation exposure, WB-MRI might be useful for evaluating multifocal ON. Larger longitudinal studies evaluating the benefits of WB-MRI for detecting the risk factors for multifocal ON are required.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13075-021-02473-3","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T08:03:30Z","timestamp":1615449810000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of whole-body modalities for diagnosis of multifocal osteonecrosis\u2014a pilot study"],"prefix":"10.1186","volume":"23","author":[{"given":"Shunichi","family":"Yokota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukie","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Asano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohsuke","family":"Kudo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norimasa","family":"Iwasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6760-3066","authenticated-orcid":false,"given":"Tomohiro","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"2473_CR1","unstructured":"Matthews AH, Davis DD, Fish MJ, Stitson D: Avascular Necrosis. 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