Introduction Intraosseous lipoma is an uncommon entity that presents almost exclusively as a solitary lesion. Multiple intraosseous lipomas are exceedingly rare with only a few cases being reported in the literature. Case presentation We present a case of 43-year-old African American female who presented with left leg and left wrist pain. The initial radiographs revealed well-defined radiolucent lesions in multiple bones involving the left wrist and the left lower limb. The magnetic resonance demonstrated multiple lesions, which showed high signal on the T1 and low signal on the fat suppressed T2 images. This favored the diagnosis of intraosseous lipomatosis that was confirmed by biopsy. Conclusion Multiple intraosseous lipomatosis is an uncommon but important differential for multiple radiolucent lesions on the plain radiographs. This condition can lead to pathological fractures. Magnetic resonance imaging can aid in providing an accurate diagnosis. The awareness of this condition can help the clinician in guiding the correct diagnosis and management.
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