A 32-year-old male truck driver diagnosed with testicular cancer in 2013. He underwent surgery to remove the tumor and, due to complications, remained hospitalized for 3 months. He then underwent chemotherapy and bone scintigraphy, which showed no pattern indicative of bone metastasis. Previously healthy, he practiced physical activity regularly and denied comorbidities. Currently complaining of constant pain in the medial region of both thighs, worse on the left, with start 5 months ago. A new bone scintigraphy (99mTc-MDP) was requested.

Image 1: Bone scintigraphy with 99mTc-MDP

Question:
Analyzing the clinical case and the findings of the scintigraphy, which is the most probable diagnostic hypothesis: