Question: Question linked to image no. 5 A 41-year-old man referred for presenting for more than 5 years bilateral alternating gluteal pain predominantly nocturnal, which interferes with sleep and relieves with mobilization. It is accompanied by stiffness for more than 1 hour after inactivity. Denies pain, swelling or deformity to another level. It provides elementary analytics without alterations except PCR 11.5 mg / dl (N <5) and the attached radiograph. The objective radiological alteration and the most probable diagnosis would be: 
 Options:  <1> Fracture of Looser- Osteomalacia. <2> Bilateral sacroiliitis - Ankylosing spondylitis. <3> Coexistence of lytic and blastic lesions Paget's disease. <4> Blastic lesions - Prostatic adenocarcinoma with bone metastases. <5> Osteosclerosis - Lymphoma.
2