Question:medium
A short fourth metacarpal is a feature of which condition?
A short fourth metacarpal is a feature of which condition?
Show Hint
Think of PTH resistance and the Albright hereditary osteodystrophy phenotype.
Updated On: Jun 24, 2026
- Hyperparathyroidism
- Acromegaly
- Pseudohypoparathyroidism
- Scleroderma
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: The clue is brachymetacarpia of the fourth ray, the metacarpal sign, where the fourth metacarpal head sits proximal to the line drawn across the fourth and fifth heads.
Step 2: The endocrine condition classically linked to this is pseudohypoparathyroidism, in which target tissues fail to respond to PTH. Its Albright hereditary osteodystrophy phenotype includes a round face, short stature and shortened metacarpals.
Step 3: A short fourth metacarpal is also catalogued in pseudopseudohypoparathyroidism, Turner syndrome, prior trauma or infection, hereditary multiple exostoses and chondroectodermal (Ellis-van Creveld) dysplasia.
Step 4: Hyperparathyroidism instead resorbs bone subperiosteally and at the tufts, while scleroderma produces tuft resorption with calcinosis. Neither gives a short metacarpal, so the answer is pseudohypoparathyroidism.
\[\boxed{\text{Pseudohypoparathyroidism}}\]
Step 2: The endocrine condition classically linked to this is pseudohypoparathyroidism, in which target tissues fail to respond to PTH. Its Albright hereditary osteodystrophy phenotype includes a round face, short stature and shortened metacarpals.
Step 3: A short fourth metacarpal is also catalogued in pseudopseudohypoparathyroidism, Turner syndrome, prior trauma or infection, hereditary multiple exostoses and chondroectodermal (Ellis-van Creveld) dysplasia.
Step 4: Hyperparathyroidism instead resorbs bone subperiosteally and at the tufts, while scleroderma produces tuft resorption with calcinosis. Neither gives a short metacarpal, so the answer is pseudohypoparathyroidism.
\[\boxed{\text{Pseudohypoparathyroidism}}\]
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