Paget disease of bone — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

EasyMetabolic bone diseasePaget disease of boneSCE Rheumatology

A 33-year-old woman has skull enlargement and deep aching tibial pain. Examination shows the tibia is bowed and warm. Investigations show alkaline phosphatase is raised with normal calcium. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Paget disease of bone

Paget disease of bone is the best answer because the pattern described is most consistent with Paget disease of bone, including the distribution of symptoms and the targeted investigation results. Osteoarthritis is a plausible distractor, but it does not account for the key discriminator in the stem. Neonatal lupus risk and Axial spondyloarthritis would be more appropriate in a different clinical pattern or at another point in the pathway, while ANCA-associated vasculitis is suboptimal for this presentation. Clinical pearl: in SCE-style questions, the decisive clue is usually the pattern across joints, extra-articular features and targeted immunology rather than a single antibody result.

Reference: NICE CG146; NOGG guideline; BNF