Evaluation of short stature.

Patients with short stature may go unrecognized if routine, accurate growth measurements are not performed by primary care physicians: This cannot be overemphasized. An accurate assessment of growth requires reliable growth measurements and proper plotting of growth data on correct growth charts. This should be done by the primary care physician yearly and at every office visit. When evaluating a child for short stature, previous growth data, diet history, birth history, the parents' heights, and parents' pubertal history are extremely important. Most children with short stature do not have endocrine abnormalities. Instead, variations of normal or chronic, nonendocrine illnesses may be present. In many nonendocrine conditions poor growth may be the only presenting problem. If the diagnosis is not readily discernible by history and physical examination, screening laboratory studies individualized for each patient may provide diagnostic clues. In some children other specialized testing is required, such as chromosomal analysis or GH testing. The therapy, if any, of short stature will of course depend on the underlying etiology. Often reassurance is all that is necessary.