Short stature

Definition

Short stature refers to any person who is significantly below the average height for a person of the same age and sex -- specifically, the shortest 3 - 5% of the population.

The term often refers to children or adolescents who are significantly below the average height of their peers.

Considerations

Short stature is not necessarily a symptom or sign of a health problem. 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. Since many of these conditions are treatable, the person should be examined by a health care provider. The rate of growth over time is important in determining the cause.

Causes

• Achondroplasia
• AIDS
• Chronic diseases such as congenital heart disease, kidney diseases, asthma, sickle cell anemia, thalassemia, juvenile rheumatoid arthritis, and diabetes
• Craniopharyngioma
• Cushing's disease
• Delayed puberty (causes temporary short stature, but normal height is eventually achieved)
• Down syndrome
• Hypopituitarism
• Hypothyroidism that develops before birth
• Inflammatory bowel disease
• Malabsorption disorders such as celiac disease
• Malnutrition
• Pituitary dwarfism
• Precocious puberty
• Rickets
• Russell-Silver syndrome
• Turner syndrome

This list is not all-inclusive.

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.

When to Contact a Medical Professional

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.

The health care provider will perform a physical examination. The child's height, weight, and arm and leg lengths will be measured. If the short stature appears to be a sign of some medical abnormality, further tests including laboratory studies and x-rays may be needed.

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

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

If the short stature appears to run in the family or is due to delayed growth, a bone age x-ray will be done. This test determines if the bone age is appropriate for the patient's age. For instance, if an 8-year- old child is only as tall as a 6 year old, the bone age x-ray 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 syndrome.

Other tests may include:

• Complete blood count
• Electrolyte levels

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