Short stature and poor linear growth

Short stature is defined by position; it is investigated because of velocity. Pair every cut-off with the serial trend and the family target. [2] [17]

Overview & Definition

Short stature is a descriptive auxological label, not a diagnosis. It means a child's height is more than two standard deviations below the mean for age and sex — roughly at or below the 3rd centile on a standard growth chart. About one child in forty sits there by definition, and most are healthy. [2] [5]

The clinical question is never "is this child short?" The question is "why is this child short, and is linear growth still on track?" A single low measurement answers the first part only. Serial measurements answer the second, and that is the part that matters. Growth velocity — the speed of change over time — separates the healthy short child from the child with a growth disorder. [2] [6]

Poor linear growth, or growth failure, is the loss of height potential: a child whose height centile falls across the chart, or whose velocity drops below the normal range for age. This may be the first sign of systemic disease, hormone deficiency, a genetic syndrome, undernutrition, or neglect. The fellowship task is to move from a low point on a chart to a defensible cause, using position, velocity, proportion and family context — then to choose observation, investigation or cause-directed therapy. [1] [6]