Long-Standing, Painful Deformation of the Right Tibia

Long-Standing, Painful Deformation of the Right Tibia

A 57-year-old man presented with long-standing, painful deformation of the right tibia. He reported increased volume of the right leg since late adolescence and three low-impact fractures in the fourth decade of life. He was treated 15 years before presentation with calcitonin for 6 months, without symptomatic relief.

What’s the diagnosis ?