60 yrs old male with bony abnormality at upper tibia associated with sensorineural hearing loss. On laboratory examination serum alkaline phosphatase levels are (440mU/I) elevated and serum Ca ++ and PO4- are normal, Skeletal survey shows ivory vertebrae and cotton wool spots in x-ray skull.Diagnosis is -
High-Yield Explanation
Increased serum alkaline phosphatase
Normal calcium and phosphate
Bony lesions in skull and vertebrae
Sensorineural hearing loss
Amongst the given option, these feature can occur only in Paget's disease.