short stature

what is short stature defined as?

height more than 2 standard deviation below the mean for their age and sex = being below the 2nd centile

how do you calculate a predicted height for a boy?

(mother height + father height + 14cm) /2

how do you calculate a predicted height for a girl?

(mother height + father height - 14cm) /2

what are the causes of short stature?

- familial short stature

- constitutional delay in growth and puberty

- malnutrition

- chronic diseases (coeliac, IBD, congenital heart disease)

- endocrine disorders - hypothyroidism

- genetic conditions - down syndrome

- skeletal dysplasias - achondroplasia

what is a constitutional delay in growth and puberty?

a variation on normal development:

- short stature in childhood when compared with peers but normal height in adulthood

- delayed puberty and growth spurt in puberty lasts longer

- reach their predicted adult height

what is a key feature of CDGP?

delayed bone age

how can delayed bone age be assessed?

x-ray images of their wrist and hand - looking at bones and growth plates

on a growth chart, what centile loss would be a red flag?

1 or more centile drop - so refer

what centile on a one off reading would be a red flag?

<0.4th centile - so refer

what happens if the child is on the 2nd centile?

with other red flags - referral

with no red flags - monitor

what is a red flag in terms of the mid-parental centile height?

if >3 centiles lower than mid-parental centile height = referral

what are the red flags with growth?

- GI problems

- weight loss

- headache (SOL)

which children qualify for growth hormone injections?

children with:

- growth hormone deficiency

- Turners

- prader willi sydnrome

- chronic renal insufficiency

- born SGA who fail to catch up

is there evidence that growth hormone therapy improves social adjustment?

no - even when they initially had emotional problems