We journey into the world of metabolic bone in this episode and explore the varied clinical manifestations of hypophosphatasia. We also interview the head of the center for osteoporosis and metabolic bone disease at the Cleveland Clinic, Chad Deal, MD. Intro :10 The four H’s of chondrocalcinosis :18 What we’ll cover in this episode :52 A general overview 2:33 The first description of hypophosphatasia 3:39 History of this condition 13:00 Two cases 16:00 The interview 17:55 Various presentations 18:42 Laboratory findings 21:13 Differentiating the terminology 24:55 The relationship between this and chondrocalcinosis 27:11 Mechanisms of pain 28:15 Treatment options 29:30 Thank you, Dr. Deal 38:00 Episode recap 38:10 We’d love to hear from you! Send your comments/questions to rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum References: Linglart A, Biosee-Duplan M. Curr Osteoporos Rep. 2016;14:95-105. Rathbun JC. Am J Dis Child. 1948;75:822-831. Robison R. Biochem J. 1923;17:286–293. Turan S, et al. J Clin Res Pediatr Endocrinol. 2011;3:7-11. Whyte MP. Bone. 2017;102:15-25.