A 60-Year-Old Man Comes to the Physician Because of Progressive

A 60-year-old man comes to the physician because of progressive pain in his right hip and lower back over the past 4 weeks. He describes the pain as dull and constant. It is worse with exertion and at night. Over the past 2 months, he has helped his son with renovating his home, which required heavy lifting and kneeling. His father died of prostate cancer. He drinks 2-3 beers daily. Vital signs are within normal limits. Examination shows localized tenderness over the right hip and groin area; range of motion is decreased. Hearing is mildly decreased on the right side. The remainder of the examination shows no abnormalities. Serum testing for which of the following would most likely help establish a diagnosis in this patient?

A) 25-hydroxyvitamin D level
B) Alkaline phosphatase level
C) Erythrocyte sedimentation rate
D) Parathyroid hormone level
E) Prostate-specific antigen level

Correct Answer:

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