A 67-year old male presents to the hand clinic

A 67-year old male presents to the hand clinic with complaints of a bump and pain in his right hand. He initially started to feel the pain about 3 months ago but thought he may have bruised the hand and did not seek help. Now the pain is continuous. He is a type 2 diabetic, has hypertension, eczema, and peripheral vascular disease. He is a 1 ppd smoker x 30 years and drinks alcohol regularly. His medications include metformin, enalapril, HCTZ, topical hydrocortisone, and aspirin. The x-ray of his hand is shown below. The radiologist feels that the lesion in the hand may be a secondary because of his age. What is the next step in his investigation?

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A. CT Abdomen
B. Endoscopy
C. Chest X-ray
D. Bone marrow biopsy