Short Stature

Short

1. Short stature Mohammed Al Shehhi Family medicine resident

2. Objectives How to approach child with short stature? How to differentiate between normal and pathological cause of short stature?

3. Short stature Short stature is defined as a height that is 2 standard deviations (SD) or more below the mean height for individuals of the same sex and chronologic age in a given population or below 3 rd percentile.

4. Differential diagnosis of short stature

5. Short stature evaluation History & Physical examination Growth assessment Growth velocity Midparental height Bone age

6. History & Examination

7. Growth parameters

8. Growth velocity Growth velocity >=5cm Pathological <5cm

9. Midparental height Boys [Paternal height (cm) + 13 cm + maternal height (cm)] ÷ 2 Girls [Paternal height (cm) – 13 cm + maternal height (cm)] ÷ 2

10. Projected height Midparental height +/- 10cm Familial short stature

11. Bone age Delayed bone age in pathological and constitutional short stature

12. Familial short stature

13. Constitutional short stature

14. Pathological short stature

15. Investigations

16. Short stature evaluation

17. Treatment Recombinant growth hormone Oxandrolone (anabolic streoid ) Insulinlike growth factor Aromatase inhibitors

18. Referral

19. Conclusion History and physical examination findings should guide further evaluation for pathologic causes of short stature. Familial short stature and constitutional delay of growth and puberty are normal variants of growth. 

20. References Evaluation of Short and Tall Stature in Children. www.aafp.org/afp . Diagnostic approach to children and adolescents with short stature. www.uptodate.com

21. Thank you..