With the U.S. Food & Drug Administration’s approval in 2014 of asfotase alfa for replacement of tissue-non-specific alkaline phosphatase (TNSALP or TNAP) in juvenile-onset hypophosphatasia (HPP), rheumatologists have a responsibility to recognize the more subtle manifestations of this condition in adults to avoid missed treatment opportunities for fractures, dental loss and musculoskeletal pain. Hypophosphatasia is…