A 8 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 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:Normal. 
Abdominal examination: Soft with no organomegaly.
Musculoskeletal examination: Unremarkable.
Skin examination: Unremarkable.

 

What is(are) the most important initial investigation(s)?

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Authors

Dr. Joanna Holland

joanna.holland@iwk.nshealth.ca

Dr. Karen Forbes

Reviewers

Dr. Mumtaz Virjii

mvirji2@cw.bc.ca

Dr. Theresa Wu

theresa.wu@ahs.ca