A 80-year-old man presents with deteriorating lumbar and bilateral hip pains. He has recently been seen by his GP with symptoms of prostatism.
Full blood count is normal. Other investigations revealed:
Corrected calcium2.3 mmol/L(2.2-2.6)ESR22 mm/1st hr(1-10)Alkaline phosphatase985 U/L(60-110)Gamma-GT33 U/L(<50)Prostate specific antigen6.6 pg/L(0-6)
What is the most likely cause of this man’s pain?
(Please select 1 option)
Multiple myeloma
Osteomalacia
Paget’s disease of the pelvis
Polymyalgia rheumatica (PMR)
Prostatic carcinoma with metastases