Investigation and management of short stature

Paediatricians need to develop a strategy for assessing and managing the short child because it is a common reason for referral to paediatric services. Understanding what is normal is a key prerequisite to the appropriate assessment of the short child. Most pathological causes of short stature will be associated with clues in the history or on examination. Factors that should trigger a more detailed assessment of the short child include malaise, dysmorphic features, slow growth and small size with a normal weight centile. Establishing that the healthy short child is growing appropriately for their family size can be reassuring for the family and clinician and will facilitate discharge.