Short stature is a common reason for a child to see a specialist, such as a pediatric endocrinologist. But remember, only a small number of children actually have growth disorders. If you and your doctor have decided to take the next step and have a pediatric endocrinologist examine your child, you can move toward identifying and addressing the issue, if one indeed exists.
What to expect at the specialist.
Diagnosing the cause behind your child’s growth problem is accomplished through an evaluation and some diagnostic tests. Every child is different, so the pediatric endocrinologist will choose an evaluation that best suits your child. They may ask for any or all of the following information:
Mother’s nutrition and use of alcohol, nicotine, or other drugs during pregnancy
Birth length and weight compared to gestational age
Prior medical records from your child’s primary care physician, including past growth measurements, illnesses, surgeries, or hospitalizations
Eating and playing habits
Participation in social events
Emotional or physical traumas
Information on birth parents
When birth parents went through puberty
Diseases (such as celiac disease) that run in the parents’ families
A complete physical exam will include measuring height and weight. Other measurements may include:
Head circumference – the length around your child’s head
Arm span – the length from the tip of one hand to the other with outstretched arms
The ratio between upper and lower body measurements
Body composition (percent of lean muscle and fat)
Evaluation of growth.
Using a growth chart, the doctor or nurse will compare your child’s height and weight with the statistical norm. This is the average height and weight of children who are the same age and sex.
Blood tests may be ordered to evaluate your child’s general health, and to rule out medical conditions such as celiac disease, cystic fibrosis, and Crohn’s disease as the cause of your child’s growth issue.
The stimulation (“stim”) test
Some doctors use stimulation testing to check for growth hormone deficiency in children and adults. Because the pituitary gland releases different amounts of growth hormone throughout the day, a single test won’t accurately measure the amount of growth hormone in the blood. A stim test can tell us whether the pituitary gland releases the appropriate amount of growth hormone in response to stimulation.
The doctor may perform tests that see inside the body, such as:
Magnetic resonance imaging (MRI) test
Computed tomography (CT) scans
A bone age X–ray
The bone age X–ray is an important test to tell the doctor whether your child’s bones are developing at the right rate for his or her age. It can also show if your child still has room for growth.
If a diagnosis is made.
If your pediatric endocrinologist determines that your child has a growth disorder, you will probably have lots of questions. Here are a few you may want to ask:
What has my child been diagnosed with?
How long will my child have this condition?
What will the impact of this condition be on my child’s life?
What can I do as a parent to help manage my child’s condition?
Will my child need treatment and what will the treatment involve?
After your child is diagnosed, you’ll be presented with your options, which may include growth hormone therapy. Your pediatric endocrinologist and your health care team will assist you in developing a care plan that is best suited to your child.
Questions for the specialist.
Receiving a diagnosis of growth hormone disorder isn’t easy, but for many children, it’s also the first step to treatment. When weighing the pros and cons of taking that step, it’s helpful to have as much information as possible. Here are some treatment-related questions you may want to ask the pediatric endocrinologist:
If we were to start my child on growth hormone, when will we start to see growth?
How much growth should we expect to see?
How long would my child remain on treatment?
Does my child have any risk factors?
Are there side effects we should be aware of?
Are there any safety concerns I should know about before using growth hormone treatment?
What are the differences between the available therapies?
What should we know about storing, handling, and traveling with treatment?
Are there pros and cons of the various delivery devices?
If we start treatment, would there be patient services available?
What about financial assistance?
What can you tell me about insurance coverage?
Learn more about Josh, age 13, who is being treated with Norditropin®.
What growth hormone does.
Growth hormone plays an important role in the body. Learn more about how it works, telling bones, muscles, and other tissues to grow.