27th February 2025

A 72-year-old gentleman presents with worsening back pain on a background of previous prostate cancer

A 72-year-old gentleman presents with worsening back pain on a background of previous prostate cancer from which he is in remission. On examination, there is midline tenderness of the thoracic spine and right hip to palpation. There is no focal neurological deficit.

Routine blood tests reveal an elevated serum alkaline phosphatase of 352 U/L (45-105 U/L).

What is the most appropriate next investigation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.