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[Idiopathic short stature]
Insights
Short stature in children is defined as height below -2 standard deviation scores. Idiopathic short stature, a common form, requires excluding other causes before considering growth hormone therapy for improved outcomes.
Area of Science:
- Pediatric Endocrinology
- Genetics
- Child Development
Context:
- Childhood growth monitoring is crucial for identifying physiological and pathological events.
- Short stature is statistically defined as height below -2 standard deviation scores or the third percentile for age and sex.
- Molecular genetics advances aid in diagnosing endocrine disorders.
Purpose:
- To define idiopathic short stature (ISS) and its diagnostic criteria.
- To outline the exclusion process for other causes of short stature.
- To establish the role of growth hormone (GH) therapy in ISS.
Summary:
- Idiopathic short stature (ISS) is a heterogeneous condition of unknown etiology, excluding specific causes like GH deficiency, Turner syndrome, or chronic diseases.
- ISS is characterized by normal birth measurements, normal GH response to stimulation tests, and height SDS rates between -2 and -3.
- Criteria for initiating GH therapy in ISS include SDS rates <-2.25 or <1.2 percentile, aiming for normal adult height.
Impact:
- Accurate diagnosis of ISS is essential for appropriate management and intervention.
- Growth hormone therapy can help children with ISS achieve normal height and improve psychosocial well-being.
- Understanding the genetic and endocrine factors in ISS can lead to improved diagnostic tools and treatments.
Abstract:
Growth is a complex process and the basic characteristic of childhood growth monitoring provides insight into the physiological and pathological events in the body. Statistically, the short stature means departure from the values of height for age and sex (in a particular environment), which is below -2 standard deviation score, or less than -2 standard deviation, i.e. below the third percentile. Advances in molecular genetics have contributed to the improvement of diagnostics in endocrinology. Analysis of patients' genotypes should not be performed before taking a classical history, detailed clinical examination and appropriate tests. In patients with idiopathic short stature specific causes are excluded, such as growth hormone deficiency,Turner syndrome, short stature due to low birth weight, intrauterine growth retardation, small for gestational age, dysmorphology syndromes and chronic childhood diseases. The exclusion of abovementioned conditions leaves a large number of children with short stature whose etiology includes patients with genetic short stature or familial short stature and those who are low in relation to genetic potential, and who could also have some unrecognized endocrine defect. Idiopathic short stature represents a short stature of unknown cause of heterogeneous etiology, and is characterized by a normal response of growth hormone during stimulation tests (>10 ng/ml or 20 mJ/I), without other disorders, of normal body mass and length at birth. In idiopathic short stature standard deviation score rates <-2.25 (-2 to -3) or <1.2 percentile. These are also criteria for the initiation of growth hormone therapy. In children with short stature there is also the presence of psychological and social suffering. Goals of treatment with growth hormone involve achieving normal height and normal growth rate during childhood.
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