65 y/o woman - doc_ted

[ArchivalUser]

A 65-year-old woman comes to the emergency department complaining of back pain. The pain started two days prior to her visit and has been progressively worsening. She denies any fever or history of cancer. The physical examination is significant for point tenderness over the lower spine. The neurologic examination is negative. Serum chemistries obtained in the emergency department are as follows: calcium 8.7 mg/dL, phosphorus 3.2 mg/dL, and alkaline phosphatase 73 U/L. What is the most likely diagnosis?

(A) Osteoporosis
(B) Osteomalacia
© Paget's disease
(D) Multiple myeloma
(E) Metastatic bone disease

[ArchivalUser]

AA

[ArchivalUser]

(A) Osteoporosis

Explanation:

Any patient with metabolic bone disease and normal serum calcium, phosphorus, and alkaline phosphatase is most likely to have osteoporosis.