A child is below the third percentile for height. His growth velocity is normal, but chronologic age is more than skeletal age. The most likely diagnosis is
sho stature: Defined as height below third centile or more than 2 standard detions below the median height for age and gender according to the population standard. Children whose stature s more than 3 SD below the population mean for age and gender are more likely to be suffering from pathological sho stature as compared to those with stature between -2 and -3SD , who are more likely to be affected by familial or constitutional sho stature. CAUSES:- 1. Most common cause is constitutional. 2. Familial 3. Pathological causes include: Undernutrition Chronic systemic illness Cerebral palsy Congenital hea disease Cystic fibrosis,asthma Malabsorption Acquired immunodeficiency syndrome 4. Endocrine causes include: Growth hormone deficiency Hypothyroidism Cushing syndrome Pseudohypoparathyroidism Precocious or delayed pubey 5. Psychosocial dwarfism 6. Children born small for gestational age. 7. Skeletal dysplasia; achondroplasia, rickets. 8. Genetic syndrome; Turner, Down syndrome. Constitutional growth delay:- These children are born with a normal length and weight and grow normally for first 6-12 months of life. Their growth then shows a decelration so that the height and weight fall below third centile. By 3 yr of age, normal height velocity is resumed abd they continue to grow just below and parallel to tge 3rd centile with a normal height velocity. Bone age is lower than chronological age and corresponds to the height age. History of delayed pubey and delayed height spu is usually present in one or both parents. Reference: GHAI Essential pediatrics, 8th edition
Constitutional delay in growth
Genetic sho stature
Primordial dwarfism
Hypopituitarism
Growth and development