Sclerotic bony metastases

Case contributed by Vikas Shah
Diagnosis almost certain

Presentation

Vague pain in both hips. Raised calcium and alkaline phosphatase.

Patient Data

Age: 75
Gender: Male

Pelvis x-ray

x-ray

Patchy sclerosis is present within the superior and inferior pubic rami on both sides of the pelvis. Mild degenerative change is seen in both hips joints. No fracture or dislocation.

Bone scan

Nuclear medicine

Intense radiotracer activity is present in the pelvic bones at the sites of abnormality on the x-ray. In addition, there are numerous other foci of activity involving the ribs, vertebrae, and left femoral neck.

Case Discussion

In an older male patient with new sclerotic bony lesions, metastasic disease from prostate carcinoma is the top differential.

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