Abnormalities of growth and development in puberty.

Disorders of grow th and pubertal development in the teenage years present as a spectrum of abnormalities embracing common normal variants, less common disease states, and rare disorders increasingly recognised and understood as genetic in origin. This brief review is intended to provide a guide to the diagnosis of problems presenting most commonly in adolescent/teenage children, to help with initial assessment and management and to stress the need for referral to appropriate endocrine or other specialist services. Long-term management of individual diagnoses is beyond the scope of this article (references are provided for further reading). In order to focus on the teenage child, precocious puberty (by definition, before the age of 8 years in girls and 9 years in boys) is not discussed, but readers can seek guidance from a recent review1.