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Answer :
Final answer:
Soft tissue prominence over the shoulders ("shoulder pad sign") are the best confirmatory diagnoses for the presented symptoms. Correct option is c .
Explanation:
The best confirmatory diagnosis for the presented symptoms would be a biopsy of the soft tissues. Considering the long duration of dialysis dependence, distribution of symptoms involving the neck, both shoulders, and hands, and the presence of soft tissue prominence over the shoulders, it is important to rule out conditions such as amyloidosis. A biopsy of the soft tissues, specifically from the affected areas, can provide definitive evidence of the presence or absence of amyloid deposits.
In addition to the soft tissue biopsy, radiographic imaging can be performed to assess for the presence of bone cysts. Bone cysts can be seen in conditions such as multiple myeloma, which can be associated with amyloidosis. Therefore, obtaining radiography to evaluate for bone cysts can provide supporting evidence for the diagnosis.
It is important to follow up with a healthcare professional for a comprehensive evaluation and definitive diagnosis.
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