Dr. Harshita Sharma
Endocrinology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
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Patient's Query
Hello doctor,
My friend's daughter, aged four years and eight months, has been identified as having a bone age significantly younger than her chronological age by her doctor. The doctor suggested the bone age resembles that of a two-year-old. This discrepancy raises concerns about her growth and development. The doctor also advised consulting a heart specialist, possibly indicating additional health considerations. I have attached the reports for further evaluation. What could this mean for her health, and should we be worried? Kindly help.
Thank you.
Hello,
Welcome to icliniq.com.
I can understand your concern.
You asked for your friend's daughter, whose bone scan shows that she is two years delayed in growth. This is serious if you think being tall is important or if she does not grow to a certain height, she will be discriminated against or deprived in some way.
Having said that, delayed growth can lead to many psychological issues, including low self-esteem, so from the point of view of her mental well-being, I would recommend treating it only if she is unable to grow taller when she enters the growth phase during puberty, around 11 years of age; because at present, her Insulin-like growth factor or IGF-1 levels are normal. She is likely to catch up with her peers during puberty, but if she does not, then there are alternatives to facilitate growth, especially if it is caused by deficient growth hormones.
None of the reports that you attached mention anything about testing for the heart or indicating that she has any issues with her heart. If there are reports that have not been attached, then I will be unable to answer this part of your query.
I hope this information will help you.
Thank you.
Patient's Query
Hello,
Thank you for your reply.
The girl is shorter than average for her age, with her mother being approximately 4 feet 11 inches and her father about 5 feet 9 inches tall. I want to ask the following questions
Is this a serious issue if she does not grow more?
Can treatment help her reach her mother's height?
Thank you.
Hi,
Welcome back to icliniq.com.
One thing I forgot to add to the previous answer - regarding the bone age (two years) being younger than her actual age (four years); all that means is that she will probably start puberty later than her peers. This means that she will have a smaller window in which to enter her puberty growth spurt. At this point, medical interventions may prove helpful.
I would not start worrying about her height right now when she is so young. We are still unsure of her genetic potential for height as she has not reached puberty yet.
Her height should be somewhere between her parents' height by the time she turns 16 to 17 years of age. That will be her natural genetic potential. However, sports like swimming and basketball can augment her height by a couple of inches.
In addition to being physically active, I would recommend keeping her diet well-balanced and making sure she sleeps well. If she grows up healthy, she will probably grow taller than her mother.
If she is still comparatively short by the age of 14-15 years, there are medical treatments available, but those would be beneficial only if her IGF-1 were low (which is normal as per the reports). But, as I mentioned earlier, that is something to think about in the future.
Today, it is important to make sure she grows up healthy and fit. In that aspect, her physical activity, diet, and sleep become the most important parameters to determine her future growth potential.
I hope this information will help you.
Thank you.
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Endocrinology
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