Short Stature for the General Pediatrician.

Short stature (SS) is among the most common reasons for referral to a pediatric endocrinology clinic, particularly in urban areas. An appropriate medical history, including family history with measurement of the parents, an evaluation of the growth chart, an appropriate review of systems and physical exam, and determining the bone age, will allow the clinician to have a clear understanding of the reason(s) why the child is short. Familial SS and constitutional delay of growth are the most common causes of short stature. Children who are small for gestational age, whose height are not normal by age 2 years, and have dysmorphic features or abnormal body proportions should have an evaluation for genetic causes of SS. Children with abnormal growth velocity should be evaluated for endocrinopathies, inflammatory conditions, intestinal malabsorption, environmental factors, and/or chromosome mosaicism. Treatment of the identified cause should restore normal growth. Growth hormone treatment is only required by a minority of patients with SS.