This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: AIIMS 2019, Subject name: Orthopaedics
A 55 yr old patient presented to the opd with complaint of pain in back. On examination his limbs seemed to be bent with overlying warm and thick skin. Patient also complain of decreased hearing over a few days. On biochemical analysis his serum ALP was raised. X-ray obtained showed the following features. Most probable diagnosis? 
Select and explain. 
A. Osteoporosis, B. Osteopetrosis, C. Pagets disease, D. Renal osteodystrophy
C: Pagets disease
Answer: C: Pagets disease 
Explanation: Given scenario suggests diagnosis of Paget's disease. Image shows- a) Ivory veebra, b) Picture frame veebra Osteoporosis- Cod fish veebra Osteopetrosis- bone within a bone appearance Renal osteodystrophy- Rugger jersey spine