Short stature. Part II
Rimoin, D.L.; Horton, W.A.
Journal of Pediatrics 92(5): 697-704
1978
ISSN/ISBN: 0022-3476 PMID: 347041 Document Number: 130415
A pathophysiologic background is provided for the evaluation of short stature by outlining the normal human growth curve, the physiologic mechanisms that participate in the growth process, and the manner in which these processes can be disturbed. Each normal individual follows a growth curve that is accompanied by orderly and well-correlated changes in body proportions, dental eruption, and epiphyseal ossification. All of these are primarily dependent upon the individual genetic constitution, but may be altered, either permanently or transiently, by influences such as nutrition and chronic disease. In order to judge whether a child has normal growth and maturational development, standard normal curves are required. In the presence of normal substrate and the absence of disease, growth is regulated by an interaction of the endocrine glands with the skeletal system. Pituitary growth hormone is the major stimulus for normal growth. The regulation of endochondral ossification is poorly understood, but presumably results from an interaction of the chondrocyte with a variety of endocrine factors. A variety of processes that disturb chondrocyte proliferation, maturation, or transformation to bone, whether intrinsic to the chondrocyte, secondary to decreased substrate, or to a disturbance in endocrine regulatory factors, can result in a decrease in endochondral ossification and subsequent short stature.