Figure 1. Albright’s hereditary osteodystrophy (AHO) and characteristic skeletal abnormalities. A) A child with AHO exhibiting short stature, obesity, and round facies. B) The hand X-ray of a patient with AHO, displaying brachydactyly of the fourth and fifth metacarpal bones. C) Dimpling over the knuckles of a clenched fist (also known as Archibald sign), indicating the short metacarpals. D) Evidence of brachydactyly in the hand, reflecting the shortened fourth and fifth metacarpals and the distal phalanx of the thumb. Images are from: Levine, MA (139).