Case history
Case history #1
A 15-year-old boy is concerned as he is much shorter than his peers and is being bullied at school. He is reluctant to go swimming with his friends as they are taller and more physically developed than him. His 13-year-old sister is also taller than him. On exam his height is on the 2nd centile, and midparental height is on the 50th centile. He is prepubertal with testicular volumes of 3 mL bilaterally. An x-ray of his wrist reveals a bone age of 12.8 years.
Case history #2
The parents of a 14-year-old girl present with concerns that she is short and has not started her periods. On exam her height is well below the 0.4th centile and her weight is on the 25th centile. Her previous growth records indicate that her height at 2 years was on 75th centile and at 8 years had fallen to the 25th. The parents are both measured at the visit and the midparental height is calculated to be on the 91st centile. She has slightly large ears with minimal webbing of the neck. Her birth was uneventful at 39 weeks; she weighed 3 kg and has remained well. She struggles with math but is above average in reading and writing.
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