A 12 year old girl is brought to the clinic by her father because of concerns that she is shorter than other children her age. She has a history of wheezing with viral illnessess as a toddler. Family history reveals that both parents are of average height and mom's menarche was at age 14. On examination, she is well appearing with no dysmorphic features. Plotting her growth reveals the following: All growth parameters are at the fifth percentile.

Respiratory examination: Normal. 
Cardiovascular examination:Within normal limits. 
Abdominal examination: Normal.
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