Assessment of the short child

Short stature is a common problem presenting to the paediatric clinic and frequently causes a degree of psychological distress amongst parents and children. A systematic approach to the problem usually differentiates common variations of normal physiological growth and short stature due to chronic disease from less common endocrine pathology. A clear understanding of the factors influencing normal growth through infancy, childhood and puberty is an essential requirement if normality is to be distinguished from pathology. This review summarises factors involved in the attainment of normal growth and provides a framework for assessing the short child, based on the history, examination, auxology and investigation findings.