What is included in the physical exam to evaluate short stature?

Updated: Jan 06, 2021
  • Author: Sunil Kumar Sinha, MD; Chief Editor: Robert P Hoffman, MD  more...
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Answer

Palpate for thyroid enlargement and firmness, which can be associated with Hashimoto thyroiditis, the most common cause of acquired hypothyroidism.

Test visual fields for signs of pituitary and hypothalamic tumors, initially by gross confrontation.

Inspect fourth metacarpals, which are shortened in persons with pseudohypoparathyroidism, Ullrich-Turner syndrome, and Albright hereditary osteodystrophy. Fifth finger clinodactyly is seen in Silver-Russell syndrome.

Inspect mucous membranes for ulcerative stomatitis, typical of Crohn disease and various trace mineral and vitamin deficiencies.

  • Pretibial ulcerations are also observed in persons with Crohn disease and ulcerative colitis.

  • Rectal tags and clubbing are also typical in individuals with Crohn disease.

Confirm the history with direct measurements whenever possible. For example, measure both biologic parents' heights during the clinic visit.


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