Short stature . Diagnosis and treatment

For a pediatrician the assessment of growth and body size of a child is an important means to assess the organic and psychosocial health. While by definition a body size <-2 standard deviation scores (SDS) below the gender and age-adjusted mean represents short stature, a low growth rate often represents an early indication of an underlying pathological disorder. As the list of the underlying causes of short stature is very long, a structured approach and the classification into diagnostic categories, such as short stature due to intrauterine growth retardation or postnatal short stature with normal or abnormal body proportions are recommended. For some diagnoses there may be indications for treatment with biosynthetic human growth hormone but this should follow a guideline-based decision-making process and in some cases an individual weighing up of the expected diagnosis-specific therapeutic success compared to potential risks of therapy is necessary.