Bone and joint abnormalities occur frequently in sickle cell anemia but are rare in sickle cell trait. Long bone diaphyseal infarctions are distinctly unusual in sickle cell trait. We describe a patient with AS hemoglobin and symptomatic bone infarctions in the diaphyses and metadiaphyses of the long bones of the lower extremities and in the calcaneus. In addition, this patient manifested noninflammatory synovial effusions of the knee. The bone and joint manifestations of sickle cell trait are reviewed in the context of this case.