Hypophosphatemic Osteomalacia due to Adefovir-induced Fanconi Syndrome

A 74-year-old Chinese woman presented to the emergency department with history of worsening generalized myalgia and bone pain, which she had been experiencing for two years. The pain was most severe over her bilateral shoulders, hips and upper back, and worsened by movement and weight bearing. Her symptoms had gradually caused her to become wheelchair bound over this duration. There was no history of falls or trauma. She denied fever, other infective symptoms, early morning stiffness or focal weakness.