[Normal growth and disorders of growth in children and adolescents (author's transl)]

Normal growth and its variability are discussed on the basis of the new Zürich standard percentile charts. In the perinatal period boys grow faster than girls, presumably because of higher concentration of plasma testosterone. At the age of 6-7 years there is a modest midgrowth spurt, presumably caused by the increasing secretion of adrenal androgens (adrenarche). Just before puberty growth velocity reaches its lowest point. This is followed by the pubertal growth spurt with its peak at a mean age of 12 years in girls and 14 years in boys. This growth spurt is more marked in boys and is caused by the increasing secretion of gonadal steroids (gonadarche). Three or four years later growth ceases. Growth and bone maturation are closely related. In both the pubertal growth spurt and bone maturation girls are two years advanced compared to boys. From height and bone age a quite accurate estimation of the timing of puberty and of adult height can be made. Height and growth velocity are independent multifactorial variables. The majority of growth problems are caused by constitutional (familial) variants of height (familial short or tall stature) and of velocity of growth and maturation (familial acceleration or delay of growth and adolescence). The causes of growth disturbances of organic origin are chromosomal aberrations (e.g., Down syndrome), dysmorphology syndromes (e.g., Russell-Silver syndrome), endocrinopathies (e.g., hypopituitary dwarfism), chronic diseases (e.g., celiac disease), and bone dysplasias (e.g., achondroplasia).