<prompt> 60 yrs old male with bony abnormality at upper tibia associated with sensorineural hearing loss. On laboratory examination serum alkaline phosphatase levels are 440mUI elevated and serum Ca and PO4- are normal, Skeletal survey shows ivory vertebrae and cotton wool spots in x-ray skull.Diagnosis is -Fibrous dysplasiaPagets diseaseOsteosclerotic metastasisOsteoporosis  <response>: Increased serum alkaline phosphataseNormal calcium and phosphateBony lesions in skull and vertebraeSensorineural hearing lossAmongst the given option, these feature can occur only in Pagets disease. 