Diagnostic approach in children with short stature

Horm Res. 2009;72(4):206-17. doi: 10.1159/000236082. Epub 2009 Sep 29.


For early detection of pathological causes of growth failure proper referral criteria are needed, as well as a thorough clinical, radiological and laboratory assessment. In this minireview we first discuss the two consensus-based and one evidence-based guidelines for referral that have been published. The evidence-based guidelines result in a sensitivity of approximately 80% at a false-positive rate of 2%. Then, relevant clues from the medical history and physical examination are reviewed, and specific investigations based on clinical suspicion listed. In the absence of abnormal clinical findings, an X-ray of the hand/wrist and a laboratory screen are usually performed. Scientific evidence for the various components of laboratory screening is scarce, but accumulated experience and theoretical considerations have led to a list of investigations that may be considered until more evidence is available.

Publication types

  • Review

MeSH terms

  • Body Height
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Growth Disorders / classification
  • Growth Disorders / diagnosis*
  • Growth Disorders / etiology
  • Humans
  • Referral and Consultation / standards*