[Growth disorders]

Growth assessment forms the basis of the management of endocrine disorders in childhood. However, it is important to emphasize that there is no clear demarcation between normal and abnormal stature and that an understanding of the various components of growth and its endocrine correlate is a basis of the logical investigations and the eventual diagnosis of growth disorders. In this context it is obvious that the definition of a tall or a short child is arbitrary. In fact, normal growth embodies many normal variants, not only terms of growing within or outside the percentiles, but also in terms of skeletal maturation and duration of puberty. It is worth reinterating that percentiles mean nothing more than the proportion of children who had reached given heights at given ages when they, the standardizing population, were measured. Therefore, percentile position in itself is of no consequence in the diagnosis or management of an individual child. To estimate the rate at which a child is growing, it is necessary to measure height on more than one occasion over a not too short period of time and to divide the increment in height by the time elapsed. As the growth of a normal child tends to follow a particular percentile an endocrine investigation becomes only necessary if a child is growing extremely quickly or slowly and if a significant deviation from the percentile lines becomes apparent.