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Short metacarpal in a patient with idiopathic hypoparathyroidism.

We present a case to emphasize that a shortened metacarpal alone cannot be a reliable distinguishing feature between idiopathic hypoparathyroidism and pseudohypoparathyroidism. These data highlight the advisability of using serum PTH levels and the response of urinary cyclic AMP (cAMP) and phosphate excretion to exogenous PTH administration for the precise diagnosis.