A 7 year old girl is brought to the clinic by her mother because of concerns that she is shorter than other children her age. She has an unremarkable past medical history. Family history reveals that both parents are of average height and the 15 year old sister just had her first period. On examination, she is well appearing. Plotting her growth reveals the following: Height and weight have been following along the third percentile since infancy.

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 and nondistended.
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