Pediatric Pseudohypoparathyroidism Etiology: hypoparathyroidism (end organ sensitivity)Imaging: short 4th + 5th metacarpal bones, soft tissue calcificationDDX: normocalcemic pseudohypoparathyroidism (pseudopseudohypoparathyroidism) Radiology Cases of Pseudohypoparathyroidism AP radiograph of the hands shows shortening of the metacarpals and an extremely short right fourth metacarpal.