A 14 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 the 15 year old sister just had her first period. On examination, he is well appearing with no dysmorphic features. Plotting his 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: 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