29th April 2024

A 60-year-old woman presents with sudden onset of severe pain in her right thigh after a minor fall in her garden.

A 60-year-old woman presents with sudden onset of severe pain in her right thigh after a minor fall in her garden. On examination, there is significant tenderness and swelling over her right femur. She is unable to bear weight on the affected leg.

Investigations:

X-ray of the right femur: A lytic lesion in the midshaft with an associated fracture

Bone scan: Multiple areas of increased uptake in the spine, pelvis, and femurs

Serum calcium: Elevated

Which is the most likely diagnosis?