A 29-Year-Old Woman Is Evaluated for Severe Left Hip Pain

A 29-year-old woman is evaluated for severe left hip pain after twisting her leg.  She has bony deformities of the lower extremities, and her mobility is limited.  The patient has a history of hyperthyroidism, which was managed with radioiodine therapy.  Menarche was at age 7, and she has regular 30-day cycles.  Physical examination shows large, hyperpigmented macules with irregular borders located on the left shoulder, left side of the neck, and left buttock.  X-ray findings are shown in the image below. Which of the following is the most likely diagnosis?

A) Ewing sarcoma
B) Gaucher disease
C) Legg-Calvé-Perthes disease
D) McCune-Albright syndrome
E) Neurofibromatosis type 1

Correct Answer:

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