Evaluation of short stature differential diagnosis of. Bone age determination ossification centers at birth. Growth deceleration is defined as a growth velocity that is below the 5th percentile for age and gender e. Diagnostic approach to children and adolescents with short stature.
Recognize what a low weightforheight ratio suggests. If your child is at the 90th percentile, this implies they are taller than 90% of children of the. The term is most commonly applied to children whose height, when plotted on a growth curve in the pedi. Most children with short stature born sga are not gh deficient. A general pediatric approach to evaluating a short child. Growth hormone in sga children abnormal patterns of gh secretion have been observed. Short stature is defined as a height that is 2 or more standard deviations below the mean for age and gender within a population below the 2. Pdf diagnostic approach in children with short stature. Gh therapy is safe and effective in short children born sga should be considered in short children born sga without catch up growth at 2 years of age. Constitutional delay in growth and puberty a child is short during most of childhood but will have late onset of puberty and end up in the typical height range as an adult because the child will have more time to grow. Approach to a child with short stature authorstream presentation. While evaluation for growthinhibiting disorders is often indicated, most children with short stature are essentially healthy.
The average height at any age is the 50 th percentile or the middle line. Upper end of humerus carpal centers 2 mo 1 center for each yr from then onwards ossification at 3 yrs. Evidencedbased guideline for referral of children with short stature and age 010 years. Treatment of short stature depends on the right diagnoses and the causative agent. Familial short stature one or both parents are short, but the child s rate of growth is normal. Distal end of femur proximal end of tibia head of humerus calcaneus talus cuboid ossification centers at 1 year. Name the two most common normal variations resulting in short stature during childhood. Short stature refers to any child who has a height well below what is typical for that childs age and sex. Characterize the growth velocities of children who have constitutional delay of growth and adolescence or familial short stature during the.