Short stature

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Definition

Short stature is refers to any person who is significantly below the average height—specifically, the shortest 5%—for a person of the same age and sex. The term may refer to children or adolescents who are significantly below the average height of their peers.

Considerations

Short stature is not necessarily a symptom or sign. Two relatively short but healthy parents may have an entirely healthy child who is in the shortest 5%.

On the other hand, short stature may be a symptom caused by a medical condition and, as many of these conditions are treatable, should be evaluated by a health care provider.

Common Causes

• Inherited and genetic factors
  
• Hypothyroidism that develops before birth
  
• Delayed puberty (causes temporary short stature, but normal height is eventually achieved)
  
• Precocious puberty
  
• Malnourishment
  
• Chronic diseases, such as congenital heart disease, Kidney diseases, Asthma, sickle cell anemia, thalassemia, juvenile rheumatoid arthritis, and Diabetes
  
• Malabsorption disorders such as Celiac disease
  
• Inflammatory bowel disease
  
• AIDS
  
• Achondroplasia
  
• Russell-Silver syndrome
  
• Hypopituitarism (pituitary dwarfism)
  
• Craniopharyngioma
  
• Rickets
  
• Turner’s syndrome

Home Care
No particular care is indicated for short stature. If short stature is associated with a treatable medical condition, then the appropriate prescribed care should be undertaken.

Call your health care provider if

If your child appears to be significantly shorter than the majority of children his or her age (or if the rate of growth has decreased or stopped), call your health care provider.

What to expect at your health care provider’s office

To learn more about possible causes, the health care provier will ask questions such as the following:

• Family history
  o How tall are the parents? grandparents?
  o How tall are the siblings (brothers or sisters)?
  o Are there other relatives that are less than average height?
  o Have any family members been diagnosed with a disorder associated with short stature (see the causes section of this document)?
  o At what age did the parents start puberty?
  
• Child’s history
  o Has the child begun to show signs of puberty?
  o At what age did puberty signs begin?
  o Has the child always been on the small side of the growth charts?
  o Was the child growing normally and then the rate of growth began to slow?
  
• Other
  o What other symptoms are also present?

PHYSICAL EXAMINATION

The health care provider will peform a physical examination—the height, weight, and arm and leg lengths will be measured in addition to a general physical examination. If the short stature appears to be a sign of some medical abnormality, further tests including laboratory studies and X-rays may be indicated.

DIAGNOSTIC TESTS

If the short stature appears to be familial in nature or merely delayed, no further evaluation will be made other than possibly a bone age x-ray to determine if the bone age is appropriate for the patient’s height age. (If an child is 8 years old and is only as tall as a 6-year old, a bone age of 6 years would suggest that growth was merely delayed and that future height should be normal.)

Girls with short stature should have a karyotype done to check for certain genetic diseases, such as Turner’s Syndrome. Other laboratory tests such as a screening complete blood count and electrolytes may be warranted. Other tests may be done depending on the other symptoms.

AFTER THE OFFICE VISIT

Although your health care provider keeps records of height and weight from routine examinations, you may find it helpful to maintain your own records of the child’s height and weight. You may want to bring these records to your health care provider’s attention if the growth seems slow or the child seems small.

If a disorder was diagnosed by your health care provider as the cause of your child’s short stature, you may want to note that diagnosis in your child’s personal medical record.

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