HY USMLE Q #1060 – Musculoskeletal

An 68-year-old man comes to the physician for a 3-month history of pain of the left distal femur. He has no past medical history. Heart rate is 100/min. Cardiac exam shows an S3 and S4. Ejection fraction is 70%. A radiograph of the left distal femur is shown. Which of the following additional findings is most likely to be seen in this patient?

  Ball-in-valve murmur
  Cardiac amyloidosis
  Decreased mineralization of bone
  Pan-systolic-pan-diastolic murmur
  Responds to aspirin test