Short Stature in Children

Accurate serial measurements of height and weight and an accurate record of growth are essential cornponents of the clinical evaluation of all children. Maintenance of a growth chart allows comparison of an individual child with a large population in terms of both percentile ranking and the determination of ‘ ‘ height age’ ‘ : the chronologic age at which the patient’s height falls on the 50th percentile. The growth chart also facilitates observations of the pattern of growth and provides the basis for calculation of growth velocity. Until recently, growth standards used in the United States were based on data accumulated more than 30 years ago. Newer standards, compiled by the National Center for Health Statistics of the United States Public Health Service, and growth charts based on these data are now generally available. The pattern of growth is of great help in the assignment of a patient to a general diagnostic category. As shown in Fig 1, children with a congenital condition interfering with growth show persistent deviation away from the normal curve from a very early age. At times this occurs before 3 to 6 months of age, and it is almost always apparent within the first 12 to 18 months of life. Children with an acquired abnormality affecting growth follow a normal curve for a variable period of time and then begin to deviate away from the norm.