A 11 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 a history of occasional constipation. Family history reveals that both parents are of average height and the child's sister has asthma. On examination, she is well appearing, but looks younger than chronologic age. Plotting her 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: Normal.
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