Pediatric disorders of stature
Assessment of a child's weight and linear growth can be the first clue to an underlying medical problem and should be a critical component of each visit to the pediatrician. Several factors influence growth, including maternal-fetal health during pregnancy, hormonal function, nutritional sufficiency, and the social environment in which a child lives. Weight and stature should be assessed at each visit to the pediatrician using calibrated scales. Short stature is defined as a height less than the 3rd percentile or two or more standard deviations (SD) below the mean for children of the same sex and age. Conversely, tall stature is defined as having a height more than two standard deviations above the mean for age and sex or two standard deviations above the mid-parental target height. Slowed growth velocity should prompt consideration of endocrine and non-endocrine disorders, but does not necessarily require immediate referral. One must consider normal variants of growth when assessing a child with short stature or slowed growth velocity. It is also important to consider etiologies for a child growing a faster rate or taller position than expected. Tall stature is often associated with other health problems, and thus early diagnosis is important.
