This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Metabolic Bone Disease, Subject name: Orthopaedics
[{'content': "A 72-year-old woman presents with bone pain and tenderness in her lower extremities and left clavicle. Laboratory studies reveal elevated serum alkaline phosphatase. X-ray spine shows \nSelect and explain. \nA. Paget's disease of the bone, B. Osteomalacia, C. Osteoporosis, D. Osteitis fibrosa cystica", 'role': 'user'}, {'content': 'Answer: D \nExplanation: Ans. D. Osteitis fibrosa cystica* The patient in this question has hyperparathyroidism from lab derangements.* The Image shows osteosclerosis with greater density at the endplates leading to multiple contiguous levels to produce an alternating sclerotic- lucent-sclerotic appearance.* This simulates the transverse bands of a rugby jersey.* These findings are seen in hyperparathyroidism and the bone changes are called osteitis cystica fibrosa.', 'role': 'assistant'}]