Diagnostic approach in children with short stature
2009-10-13
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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.
- human
- priority journal
- short survey
- radiology
- screening
- sensitivity analysis
- pathology
- psychosocial disorder
- short stature
- evidence based practice
- differential diagnosis
- physical examination
- clinical feature
- small for date infant
- hand
- Growth
- wrist
- growth hormone deficiency
- diagnostic approach route
- diagnostic procedure
- malnutrition
- false positive result
- metabolic disorder
- bone dysplasia
- Growth disorders
- Short stature
- X ray analysis
- endocrine disease
- growth disorder
- history of medicine
- iatrogenic disease
