A study of the metacarpal sign in 1,000 hands shows it to be a common normal variant, as is the equivalent sign in the feet. It is important not to confuse this variant with the gross shortening occurring in cases of pseudohypoparathyroidism or pseudo-pseudohypoparathyroidism, in which two additional signs are described which may be of help in diagnosis.
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Ronald A. Bloom (1970) studied this question.
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