An 83-year-old African American male with history of prostatectomy, was presented to the hospital in 2018 for a follow up, and was reported with severe bilateral lower extremity weakness and pain with difficulty in walking, hence required the use of wheel-chair. History He had prostatectomy in 2002 as he had prostate cancer. Since 2013 he had an elevated alkaline phosphatase level, hence he was suggested for oncology test.
In August 2016, he was diagnosed with Osteoporosis, since then he was started on alendronate, cholecalciferol and calcium. In November 2016, a bone scan test showed increased uptake in the ribs that pointed towards metastatic disease, yet they were not found in the CT of chest and the PET was negative for malignancy. After admission to the hospital In January 2018, when the patient arrived for follow up, in lieu of his condition of pain, phosphorous and Dihydroxy…
