Short stature

• What is short stature?


  Defined as a height more than 2 standard deviations below average for age & sex

  Same as being below the 2nd centile
• How can a child's height be predicted?


  Boys =\frac{\left(mothers\ height\ \left(cm\right)\ +$\ fathers\ height\ \left(cm\right)+$14cm\right)}{2}

  Girls = \frac{\left(mothers\ height\ \left(cm\right)+fathers\ height\ \left(cm\right)\ -14cm\right)}{2}
• What are the potential causes of short stature?

  Familial short stature

  Constitutional delay in growth & development

  Malnutrition

  Chronic diseases (coeliac disease, IBD, congenital heart disease)

  Endocrine disorder (hypothyroidism)

  Genetic conditions (Downs syndrome)

  Skeletal dysplasia (achondroplasia)
• What are the red flags related to short stature?


  Weight loss

  Change in bowel habit

  Dysmorphic feature

  Pubertal delay

  Symptoms of hypothyroidism -> weight gain, cold intolerance, fatigue

  Anaemia
• What Inx can be done to identify the cause of short stature?


  Physical examination (height, weight, head circumference -> plot on growth charts)

  Family height Hx

  TFTs

  Growth hormone test

  FBC

  Bone age study
• Short stature may be associated with low self-esteem and bulling at school.
• What is constitutional delay in growth & puberty (CDGP)?


  Considered a normal variation on normal development

  Short stature in childhood but normal height in adulthood

  Puberty is delayed and the growth spurt during puberty lasts longer

  Key feature = delayed bone age

  Diagnosis of exclusion