Disorders of Growth and Stature.

Growth parameters are routinely measured in general pediatrics, with the goal of identifying children with abnormalities in growth and stature. Short stature is defined as a height less than 2 standard deviations (SDs) below the mean of the “normal” population, while tall stature is defined as a height greater than 2 SDs above the mean of the normal population. Both single growth measurements and the pattern of growth over time (growth velocity) are useful in identifying children with abnormal stature. The growth velocity changes over time, with relatively rapid growth in infancy and early childhood, followed by slower growth (approximately 5 cmper year) in later childhood and then rapid growth again during puberty. There is a range of pubertal peak growth velocities of around 7 to 12 cmper year and 6 to 10.5 cm per year in boys and girls, respectively, representing approximately the 3rd to 97th percentiles. The timing of peak growth velocity varies with the age of puberty onset and frequently reflects familial pubertal and growth patterns. Overall, it is thought that geneticsmay explainmore than 80% of the variation in heights within a population. When children exhibit abnormal growth patterns, it is critical that pediatricians perform a proper diagnostic evaluation, whichmay ultimately include referral to a pediatric endocrinology subspecialist.