Clinical_Rounds_in_Endocrinology_Volume_II_-_Pediatric_Endocrinology

© Springer India 2016 45
A. Bhansali et al., Clinical Rounds in Endocrinology,
DOI 10.1007/978-81-322-2815-8_2

2 Disorders of Growth and Development: Diagnosis and Treatment

2.1 Clinical Rounds

1. Who does need to be evaluated for short stature?

Evaluation for short stature is indicated in a child whose:

• Height >3SD below the mean for age and gender
  Or


• Height <−2SD with a height velocity <−1SD over a period of 12 months
  Or


• Height velocity SDS <−2SD over a period of 12 months
  Or


• Predicted adult height >1.5SD below the target height
  Or


• Growth curve crosses downward by ≥1 centile curve in the growth chart over
  a period of 12 months

2. Why is height SDS of – 3 recommended for the evaluation of short stature?

Although a height >2SD below the mean for age and gender is used to defi ne short

stature, evaluation of short children based on this criteria yields organic etiology only

in 14 % of these children. However, when a height SD <−3 is considered for the

evaluation of short stature, the proportion of children with organic causes increases to

58 %. Nevertheless, children with height between −2SD and −3SD need careful mon-

itoring for growth velocity, and if they show faltering, they need further evaluation.

3. Does a single measurement of height suggest growth failure?

A single measurement of height does not suggest growth failure, unless the

child is extremely short (<−3SD). The serial measurement of height determined