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MCQ 5: Bone MetastasesA 72-year-old man with prostate cancer presents with new onset back pain. Which imaging modality is most appropriate for initial investigation of suspected bone metastases?A. CT scanB. MRIC. X-rayD. Bone scintigraphyE. PET scanAnswer: MRIExplanation: MRI is the most sensitive imaging modality for early detection of bone metastases. It can detect bone marrow infiltration before bone destruction occurs and provides detailed anatomical information. While bone scintigraphy is highly sensitive for detecting osteoblastic metastases, it's usually performed after MRI confirmation. CT and X-ray are less sensitive for early bone metastases. PET scan, while useful, is not typically the first-line investigation due to cost and availability.
