A 70-Year-Old Man Comes to the Clinic Due to Intermittent

A 70-year-old man comes to the clinic due to intermittent leg pain and difficulty walking.  He describes the pain as mild-to-moderate, deep, and lasting throughout the day.  The patient has a history of osteoarthritis in his hands for which he takes over-the-counter nonsteroidal anti-inflammatory drugs, but says that he never has had problems with his knees.  Physical examination shows point tenderness over the right tibia.  Laboratory studies show elevated serum alkaline phosphatase.  Bone biopsy shows haphazardly oriented segments of lamellar bone with prominent cement lines.  The initial phase of this patient's disorder involves increased activity of which of the following cell types?

A) Chondrocytes
B) Endothelial cells
C) Fibroblasts
D) Osteoblasts
E) Osteoclasts

Correct Answer:

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