43acbdFig. 1.22 A 12-year-old girl presented with hypocalcemic seizures. Note the (a) typical round
facies (b) brachydactyly (c) X-ray hand confirms the presence of short 4th and 5th metacarpals (d)
CT head depicting bilateral basal ganglia calcification
- When to consider subnormal height velocity in a child?
The mean length of a healthy newborn is 50 cm and grows at height velocity of
25 cm in the first year, 12 cm in the second year, 8 cm in the third year, and 5 cm per
year thereafter till the onset of puberty. The pubertal growth spurt is approximately
28 cm in boys and 25 cm in girls. Deviation from this normal pattern should be
considered as pathological. In addition, crossing a centile curve downward in growth
chart or height velocity <−2 SD for 12 months is subnormal and merits evaluation.- What are the causes of short stature with normal height velocity?
Majority of children with short stature have subnormal height velocity; how-
ever, the children with FSS and CDGP have normal growth velocity despite
short stature.1 Disorders of Growth and Development: Clinical Perspectives