Figure 3. Male patient with hypophosphatasia since childhood, which was mistreated as rickets. The diagnosis of hypophosphatasia was established at the age of 49 years. The patient had short stature, skull deformity, and pseudofractures (arrows) in the left foot (A), right femur (B), and right tibia (C), which compromised his gait and significantly impaired his quality of life and ability to work. After starting treatment with asfotase alfa, the patient's clinical manifestations improved.