Short Stature

Question 1

What is the definition of a short stature?

Answer 1

Height is less than 2 standard deviations below the mean compared with age and sex, or height that has passed more than 3 centiles below the mid parental height centile.

Question 2

What is the most common cause of a short stature?

Answer 2

Familial short stature or constitutional delay

Question 3

What are some common causes of short stature in babies?

Answer 3

1. IUGR
2. Nutrition deficiency or poor intake
3. Chronic illness
4. Neglect

Question 4

What is the most common cause of short stature in adolescents?

Answer 4

Constitutional delay of growth and puberty

Question 5

What are the most common causes of short stature in all ages of children?

Answer 5

Familial short stature, chronic illness, cystic fibrosis, coeliac disease, hypothyroidism, growth hormone deficiency, hypopituitarism, chromosomal, skeletal dysplasia, iatrogenic steroid use.

Question 6

What are the causes of short stature in these individual presentations?

1. Limbs and trunk disproportionate in size
2. Visual field defects
3. Dysmorphic features
4. Diarrhoea
5. Low/high BMI

Answer 6

1. Skeletal dysplasia
2. Brain tumour
3. Genetic
4. Coeliac, IBD
5. Poor nutrition, chronic illness, endocrine disorder

Question 7

How is a short stature investigated?

Answer 7

1. Growth chart, measure parental height.
2. Bone age radiology of left hand (delayed, equivalent, advanced)
3. FBC, U&Es, CRP, ESR, coeliac, TFTs
4. Karyotyping for girls (Turner’s)
5. ITT if suspecting growth hormone deficiency