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Non-familial short stature
  1. The Wessex Growth Study
  2. Southampton General Hospital
  3. Southampton SO16 6YD, UK

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Editor,—Cole's proposed new chart1would indeed detect children with non-familial short stature. Whether it would detect “hidden” pathology is less certain—data from the Wessex Growth Study suggests not. Routine investigation of all children below Tanner's 3rd centile identified eight cases of silent pathology.2 Three of these, already on or above the current 0.4th centile, would clearly have lain above it on a conditional chart (figure 1), and might easily have been dismissed as normal. Parental heights may well inform the specialist, but their usefulness in a screening programme, without a full family history, is debatable.

Figure 1

Height standard deviation score (SDS) of children with “silent” pathology plotted …

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