Clinical_Rounds_in_Endocrinology_Volume_II_-_Pediatric_Endocrinology

(singke) #1

16



  1. What is the importance of measuring body proportions in a short child?


Measurement of body proportions helps in the differential diagnosis of short
stature. The ratio of upper segment (US) to lower segment (LS) is 1.7 at birth,
1.5 at 1 year of age, 1.4 at 2 years, 1.3 at 3 years, 1.1 at 6 years, 1 at 10 years,
and 0.92–0.85 in adulthood. A short child is considered to have proportionate
short stature when US/LS ratio is in concordance with the chronological age.
The causes of proportionate short stature include growth hormone deficiency,
familial short stature, CDGP, and chronic systemic disorders. The presence of
body proportions which are disproportionate to the chronological age defines
disproportionate short stature. This can be due to either short limb or short
trunk. The causes include hypothyroidism, rickets, skeletal dysplasias, and
mucopolysaccharidosis (Fig. 1.7). An approach to a short child is depicted in
the figure given below (Fig. 1.8).

a b

Fig. 1.7 (a) Siblings with short stature due to mucopolysaccharidosis. (b) Lateral spine radio-
graph showing reduced vertebral height with anterior beaking of the lower dorsal vertebral bodies
in the same patient


1 Disorders of Growth and Development: Clinical Perspectives
Free download pdf