Pituitary MRI, Clinical and Biochemical Findings in Children With Growth Disorder: A Retrospective Comparative Study

Background Growth disorders in children have substantial consequences for physical development and long-term health. This study assesses pituitary gland MRI, clinical, and biochemical laboratory findings in children with growth disorders. Methods A retrospective analytical study was conducted at the Maternity and Children Hospital, Al-Ahsa, Saudi Arabia, including 267 children diagnosed with isolated growth hormone deficiency (IGHD), multiple pituitary hormone deficiency (MPHD), or idiopathic short stature (ISS). Demographic, anthropometric, laboratory, and MRI findings were analyzed. Results Males constituted 155 (58.1%) of the cohort. Most children were born via vaginal cephalic delivery (233, 87.3%), with no significant sex differences in birth presentation or birth weight, indicating minimal perinatal contribution to growth abnormalities. Body mass index (BMI) differed significantly between sexes (P < 0.0001). Male children were more likely to be overweight, whereas underweight was slightly more prevalent among females. Furthermore, females presented and received a diagnosis at significantly younger ages than males, with mean ages at presentation of 100.4 ± 35.5 versus 114.6 ± 33.1 months (P < 0.0009) and mean ages at diagnosis of 108.2 ± 34.6 versus 123.0 ± 33.9 months (P = 0.0005), respectively. IGHD was the most prevalent diagnosis (222, 83.1%), followed by ISS (42, 15.7%) and MPHD (3, 1.1%), with significant sex variation across diagnoses (P < 0.01). Baseline growth velocity differed significantly, being lowest in MPHD (1.7 ± 1.5 cm/year), followed by IGHD (3.3 ± 1.01 cm/year) and ISS (3.6 ± 1.1 cm/year) (P < 0.001); however, growth velocity normalized across groups after two years of growth hormone therapy (P = 0.9). Pituitary MRI findings showed a normal brain, and the pituitary gland was the most frequent MRI finding, observed in 174 children (65.2%). Among these patients, the majority were diagnosed with IGHD (139 cases, 69.9%), followed by ISS (33 cases, 19.0%), whereas only two cases (1.1%) had MPHD. This finding suggests that a substantial proportion of children with growth disorders, particularly those with IGHD, may not exhibit detectable structural abnormalities on MRI, emphasizing the functional rather than anatomical nature of many growth hormone deficiencies. Conclusion The findings of this study suggest that growth disorders in children are predominantly characterized by IGHD, are influenced more by endocrine dysfunction than by perinatal factors or overt structural brain abnormalities, and respond favorably to growth hormone therapy, which effectively normalizes growth velocity over time. These results emphasize the importance of early diagnosis, comprehensive endocrine assessment, and targeted imaging evaluation to optimize clinical outcomes in children with impaired growth.