Children with constitutional growth delay have a normal growth velocity. There will usually be a family history of delayed puberty in a parent or a sibling. Children will reach an appropriate final adult height that is within their genetic potential. This diagnosis can often be made using history (including parental and siblings’ growth and pubertal history) and thorough physical examination. If performed, a bone age X-ray will be delayed compared to chronologic age. As this child is growing at a normal rate (following a growth percentile, has a normal physical exam and unremarkable review of systems, investigations, other than a bone are, are not indicated.
Failure to thrive: Current clinical concepts. Pediatrics in Review 2011; 32: 100-108.
Evaluation of short and tall stature in children. American Family Physician 2008; 78(5): 597-604.
