Sickle cell disease is frequently associated with bone infarction resulting from vasoocclusion secondary to the sickling of red cells. Bone infarction also occurs in hemoglobin sickle cell disease and sickle cell thalassemia. The bone pain in sickle cell crisis is due to bone and bone marrow infarction. In children, infarction of the epiphyseal growth plate interferes with normal growth of the affected extremity. Radiographically, infarction of the bone coex results in periosteal elevation and irregular thickening of the bone coex. Infarction in the bone marrow leads to lysis, fibrosis, and new bone formation. Ref: Langford C.A. (2012). Chapter 336. Ahritis Associated with Systemic Disease, and Other Ahritides. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.