Evaluation of Short Stature

In many cases the diagnosis of the cause of short stature is apparent from the medical history. There will be questions about nutritional status and toxic exposures during pregnancy, difficulties in delivery, degree of pre-maturity, and an evaluation of weight-for-gestational age. The intrauterine growth charts look at the relationship among body weight, length and head circumference.

The parents need to remember their age of puberty (first menstrual cycle in mothers and when height growth stopped in fathers) since this information may suggest a tendency towards constitutional delay in growth or adolescence. The family history will focus on neurological and endocrine chronic diseases. When the pediatric endocrinologist does a physical examination they will be searching for abnormalities of nutrition and neurologic findings. If decreased nutrition is apparent, then most likely there will not be an endocrine cause for the height issue. Weigh-for-height curves are now superseded by Body Mass Index (BMI) charts. Low BMI for age may indicate malnutrition due to chronic disease,wheras elevated BMI may indicate rapid growth due to obesity