QuestionSBA
QuestionChoice
This would typically cause shoulder and hip girdle stiffness alongside systemic symptoms such as fever, anorexia, weight loss and malaise. ESR and CRP are typically raised, as this is an inflammatory condition.  Polymyalgia rheumatica would not account for the raised ALP seen in this patient.
10007667
c
Polymyalgia Rheumatica
QuestionChoice
This would present as inflammation and pain in one joint, most commonly the wrist or shoulder. It would not account for this patient’s high ALP.
10007669
e
Pseudogout
QuestionChoice
Gout typically presents with a red, hot and swollen joint. It would not account for the raised ALP, so is not the most likely diagnosis in this case.
10007668
d
Gout
QuestionChoice
This patient is presenting with bone pain and an isolated raised ALP which points us to the diagnosis of Paget’s disease. Paget’s disease can also be picked up on X ray where you may find osteolysis, increased bone size and sclerosis or pathological fractures.
10007665
a
Paget’s disease
QuestionChoice
Osteoporosis would have a normal bone profile, so would not explain this patient’s raised ALP.
10007666
b
Osteoporosis
Concept
Chapter
2693
4617
Paget's Disease
Topic
170
Clinical Chemistry
14080
A 20-year-old female presents to the GP with bone pain that began 6 months ago. The GP conducts some blood tests which come back as follows: normal serum calcium, normal serum phosphate, normal PTH, and high ALP.

Which of the following is the most likely diagnosis?
a