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27th February 2025
An 82-year-old gentleman presents with a 4-week history of pain in his left hip. The pain is exacerbated
An 82-year-old gentleman presents with a 4-week history of pain in his left hip. The pain is exacerbated on weight-bearing and has progressively worsened in severity since initial onset. There is no preceding history of trauma. He had been under active surveillance for Gleason 3+3 prostate cancer but was subsequently lost to follow-up. His PSA level at presentation was 7.6 μg/L. Blood tests and a pelvic X-ray are requested.
Investigations:
| Haemoglobin | 110 g/L (115-155 g/L) |
| White cell count | 7.0 x 10^9/L (4.0-11.0 x 10^9/L) |
| Platelet count | 389 x 10^9/L (150-400 x 10^9/L) |
| Sodium | 139 mmol/L (137-144 mmol/L) |
| Potassium | 3.6 mmol/L (3.5-5.3 mmol/L) |
| Urea | 7.0 mmol/L (2.5-7.0 mmol/L) |
| Creatinine | 150 μmol/L (60-110 μmol/L) |
| Adjusted calcium | 2.4 mmol/L (2.2-2.6 mmol/L) |
| Alkaline phosphatase | 321 U/L (45-105 U/L) |
| Prostate-specific antigen | 71 μg/L |
What is the most likely radiographic finding?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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