Short Stature Exam Flashcards
1
Q
Short stature examination
A
Dysmorphism Asymmetry Measure height, weight, HC Lower segment: pubic symphysis to ground Upper segment: height - lower segment Mid parental height - Boys (Mo + Fo + 13)/2 - Girls (Mo + Fo -13)/2
Hands: metacarpals, nails, make a fist + hands together Wrist Arms: rhizomelic shortening (thumbs on shoulders) Beighton score for hyper mobility Head Webbed neck Chest - heart sounds, rachitey rosary Abdomen Back ?scoliosis Skin ?cafe au lait Legs - bowing, reflexes
Constitutional delay, not always small, just delayed growth velocity
Investigations
- Bone age X-ray
- Karyotype
- TFT, coeliac, FBE, iron studies, CMP, PTH, IGF-1, ESR
- Consider: microarray, GH stimulation testing, skeletal survey, neuroimaging
Note:
< 2 years = length
> 2 years = height
Arm span:height should be 1:1
