Short Stature

Question 1

What is short stature?

Answer 1

Short stature is defined as a height more than 2 standard deviations below the average for their age and sex. This is the same as being below the 2nd centile.

Question 2

Predicted height formula?

Answer 2

A child’s predicted height can be calculated based on their parents’ height, measured in centimetres. The formula is different for boys and girls:

Boys: (mother height + fathers height + 14cm) / 2
Girls: (mothers height + father height – 14cm) / 2

Question 3

Causes of short stature?

Answer 3

Familial short stature
Constitutional delay in growth and development
Malnutrition
Chronic diseases, such as coeliac disease, inflammatory bowel disease or congenital heart disease
Endocrine disorders, such as hypothyroidism
Genetic conditions, such as Down syndrome
Skeletal dysplasias, such as achondroplasia

Question 4

What is a constitutional delay in growth and puberty (CDGP)?
Key feature?
Diagnosis + management?

Answer 4

Constitutional delay in growth and puberty (CDGP) is considered a variation on normal development. It leads to short stature in childhood when compared with peers but normal height in adulthood. Puberty is delayed and the growth spurt during puberty lasts longer. They ultimately reach their predicted adult height.

A key feature of CDGP is delayed bone age. It is possible to estimate the age of a child using xray images of their wrist and hand by assessing the size and shape of the bones and the growth plates. Children with CDGP will have a delayed bone age compared with the reference for their age and sex.

Diagnosis is based on a suggestive history and examination and can be supported by an xray of the hand and wrist to assess bone age. Management involves excluding other causes of a short stature and delayed puberty, reassuring parents and the child and monitoring growth over time.