Short stature and its treatment.

The axiom that diagnosis must precede treatment holds true for the management of short stature. What matters is the current rate of growth and the potential for further growth; it is essential to measure accurately the rate of gain in height and the radiological bone age. Early detection of subnormal rate of growth can lead to prevention of dwarfism, but a dwarf with epiphyses closed is beyond remedy. A child's rate of gain in height is determined by genetic factors that require a benign internal environment for their full expression. No form of therapy can alter a genetically determined height velocity; treatment is possible if an adverse internal environment can be corrected. Smith' gave an excellent account of the various forms of dwarfism, including the many