A 12 year old boy is brought to the clinic by his mother because of concerns that he is shorter than other children his age. He has a history of occasional constipation. Family history reveals that both parents are of average height and mom's menarche was at age 14. On examination, he is well appearing, but looks younger than chronologic age. Plotting his growth reveals the following: All growth parameters are at the fifth percentile.

Respiratory examination: Normal. 
Cardiovascular examination:There is a grade 2/6 systolic ejection murmur at the left lower sternal border that is best heard when the child is supine. 
Abdominal examination: Soft with no organomegaly.
Musculoskeletal examination: Unremarkable.
Skin examination: Normal.

 

The most likely diagnosis for this child’s short stature is?

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Authors

Dr. Joanna Holland

joanna.holland@iwk.nshealth.ca

Dr. Karen Forbes

Reviewer

Dr. Mumtaz Virjii

mvirji2@cw.bc.ca