الفهرس 
Physiology of Growth
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Abstract
Growth is an important objective parameter of general health of a child. Normal growth is the result of the proper interaction of genetic, nutritional, metabolic and endocrinal factors.
Height is the best simple index for assessment of growth among children and adolescents. The most important tool for assessing and monitoring a child’s growth is the growth chart.
Short stature is a common problem encountered by practicing pediatricians.
The aetiology of short stature ranges from normal variant like familial short stature to pathological short stature.
Our study aimed at finding out the different causes of short stature, and the degree of shortness in each cause.
It was conducted on 100 short children consecutively presenting to the outpatient clinic in pediatric hospital, Ain-Shams University.
All children in the study were subjected to full detailed medical history, thorough clinical examination,
including:
auxological measurements, as child’s height, weight, upper segment to lower segment ratio. General and systemic examination, Tanner staging.
A list of investigations was done to detect the cause including:
Bone age, CBC, ESR, karyotype for short females, hormonal profiles including growth hormone assessment and thyroid function tests.
The study classified the causes of short stature into 8 groups, the commonest cause was chronic systemic disorders(30%) followed by endocrinal causes(17%) of which growth hormone deficiency was at the top of the list, then followed the genetic causes(12%) and the syndromatic causes(12%). The least common cause was the normal variant short stature(2%).
Also our study showed that patients with Turner syndrome were the shortest among all genetic causes and patients with skeletal dysplasia were the shortest among all studied groups.
Also patients with endocrinal causes especially growth hormone deficient patients had more delayed Tanner staging than all the other groups.
The SDS of bone age is more delayed in patients with growth hormone deficiency.
Patients with inborn errors of metabolism, those with chronic systemic disorders and with endocrinal causes were most affected by anemia.
from our study we concluded that normal variant short stature is underestimated in our population, and that early neonatal screening for thyroid hormones resulted in marked decrease in the percentage of hypothyroidism as a cause of short stature.