Disorders of growth

Most children who have short or tall stature are healthy and just at the extremes of the normal range. Plotting a child on a centile chart and following the growth pattern over time helps to assess whether the pattern of growth is normal – a normal growth pattern confirms that the hormonal control of growth is normal. During puberty, sex steroids stimulate growth directly and increase growth hormone (GH) secretion, leading to the pubertal growth spurt. Any short child whose pattern of growth is abnormal (reduced growth velocity) should be investigated. GH treatment is indicated for GH deficiency and a number of other defined short stature conditions. Most children referred to the clinic with concerns about growth will not benefit from GH treatment but media and internet information means that GH is often the focus of discussions.