A 55 yr old patient presented to the opd with complaint of pain in back. On examination his limbs seemed to be bent with overlying warm and thick skin. Patient also complain of decreased hearing over a few days. On biochemical analysis his serum ALP was raised. X-ray obtained showed the following features. Most probable diagnosis?

Explanation

Given scenario suggests diagnosis of Paget's disease. Image shows- a) Ivory veebra, b) Picture frame veebra Osteoporosis- Cod fish veebra Osteopetrosis- bone within a bone appearance Renal osteodystrophy- Rugger jersey spine