Short stature refers to any person who is significantly below the average height for a person of the same age and sex.
The term often refers to children or adolescents who are significantly below the average height of their peers.
Idiopathic short stature; Non-growth hormone deficient short stature
A growth chart is used to compare a child's current height and how fast he or she is growing to other children of the same age and gender (male or female). A measurement called standard deviation (SD) is used. If a child's height is more than 2 SD's below the average height, the child is thought to have short stature.
Many parents become worried if their children are shorter than most or all of the children around them. However, 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. Because 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.
Short stature may be due to a number of medical conditions or problems, including:
Short stature that has no medical cause (idiopathic short stature) can be due to:
This list does not include every possible cause of short stature.
All children should have their growth and development monitored on a regular basis.
If your child appears to be much shorter than most children his or her age (or if the growth rate 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 condition, 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:
A bone age x-ray is often done. X-rays are usually made of the left wrist or hand. Normally, the size and shape of bones change as a person matures. These changes can be seen on an x-ray and usually follow a pattern as a child grows older. Certain causes of short stature may be present if the bones have not changed or matured as expected for the child's age.
Girls with short stature may have a karyotype done to check for certain genetic diseases, such as Turner syndrome.
Other tests may include:
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.
Children of short stature who are found to have a lack of growth hormone in their body will usually be treated with growth hormone injections.
Growth hormone injections are also used to treat children with Turner syndrome, Prader-Willi syndrome, chronic kidney failure, or idiopathic short stature (ISS).
Many children with short stature of unknown cause do not need growth hormone injections. Children who are more likely to receive growth hormone injections are:
Some boys with short stature who also have delayed puberty may receive certain medicines containing the male hormone, testosterone.
Cohen P, Rogol AD, Deal CL, et al. Wit JM: 2007 ISS Consensus Workshop participants. Consensus statement on the diagnosis and treatment of children with idiopathic short stature: a summary of the Growth Hormone Research Society, the Lawson Wilkins Pediatric Endocrine Society, and the European Society for Paediatric Endocrinology Workshop. J Clin Endocrinol Metab. 2008;93:4210-4217.
Parks JS, Feiner EL. Hypopituitarism. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 558.
Collett-Solberg PF, Misra M. Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. The role of recombinant human insulin-like growth factor-1 in treating children with short stature. J Clin Endocrinol Metab. 2008;93:10-18.