A 47 year old woman presents to her physician complaining of pain in her left leg that worsens on standing and walking. She had undergone menopause at the age of 46 with no hormonal therapy. She also complains of long standing diarrhea. An x-ray shows demineralization and EDTA shows reduction in bone quantity. Her laboratory tests show low calcium and phosphorus levels and high alkaline phosphatase level. They also show decreased level of 25-hydroxyvitamin D. Bone biopsy shows uncalcified osteoid on all bone surfaces. According to all these data, what is the most likely diagnosis of this patient's condition? A- Paget's disease of bone B- Osteoporosis C- Osteomalacia D- Hypoparathyroidism Answer: http://medical-usmle.com/?p=1267
