10th August 2020

An 89-year-old male patient has come in today for review of his medication

An 89-year-old male patient has come in today for review of his medication. He complains of generalised pain in his bones – described as a dull ache. He has no other symptoms apart from a recent admission to hospital for an episode of decompensated heart failure which he recovered from. On examination he has MRC grade 5. He experiences pain on palpation of bony prominences in his limbs but not in his muscles. The GP decides to check his bloods which were recorded during his recent hospital admission. They show: Calcium 2.14, Phosphate 0.96, Vitamin D 87, PTH 7.0, ALP 300. What is the most likely diagnosis?

Normal data levels:

Calcium= 2.12-2.65

Phosphate= 0.85-1.45

Vitamin D= 60-105

Parathyroid Hormone PTH= 0.8-8.5

Alkaline Phosphatase ALP= 30-150

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.