Constitutional short stature

Constitutional Short Stature
Synonyms	Idiopathic short stature
Pronounce	N/A
Specialty	N/A
Symptoms	Short stature
Complications
Onset	Childhood
Duration	Lifelong
Types	N/A
Causes	Genetic predisposition
Risks
Diagnosis	Clinical evaluation, growth charts
Differential diagnosis	Growth hormone deficiency, Turner syndrome, Hypothyroidism
Prevention	N/A
Treatment	Observation, reassurance
Medication	N/A
Prognosis	Good
Frequency	Common
Deaths	N/A

Constitutional short stature (CSS) is a condition characterized by a height significantly below the average for a person's age and sex, without any identifiable medical cause. It is often considered a variant of normal growth and development.

Epidemiology

Constitutional short stature is a common condition, affecting a significant number of children worldwide. It is more frequently observed in males than females. The condition is often familial, with a history of short stature in one or both parents.

Etiology

The primary cause of constitutional short stature is believed to be genetic. Children with CSS typically have a normal growth velocity and reach a final adult height that is consistent with their genetic potential. Unlike other causes of short stature, such as growth hormone deficiency or chronic illness, CSS is not associated with any underlying pathological condition.

Pathophysiology

In constitutional short stature, the growth pattern is normal but delayed. Children with CSS often have a delayed bone age, which means their skeletal development is younger than their chronological age. This delay in bone maturation is usually followed by a catch-up growth phase during puberty, allowing these individuals to reach a height within the normal range for their genetic background.

Clinical Presentation

Children with constitutional short stature present with:

• Height below the 3rd percentile for age and sex on standardized growth charts.
• Normal growth velocity.
• Delayed bone age on radiographic examination.
• Normal physical examination findings without signs of systemic disease.

Diagnosis

The diagnosis of constitutional short stature is primarily clinical. It involves:

• Detailed medical history, including family history of short stature.
• Physical examination to rule out other causes of short stature.
• Growth chart analysis to assess growth patterns over time.
• Bone age assessment using hand and wrist X-rays.
• Exclusion of other conditions such as growth hormone deficiency, Turner syndrome, and hypothyroidism.

Management

Management of constitutional short stature involves:

• Reassurance to the child and family about the benign nature of the condition.
• Regular monitoring of growth and development.
• Psychological support if necessary, to address any concerns about self-esteem or social interactions.
• In some cases, referral to a pediatric endocrinologist for further evaluation may be considered.

Prognosis

The prognosis for children with constitutional short stature is excellent. Most children will experience a normal pubertal growth spurt and achieve an adult height within the lower range of normal for their genetic potential. There are no long-term health consequences associated with CSS.

See also

• Short stature
• Growth chart
• Bone age

External links

• [Link to a reputable medical resource on short stature]