The role of the primary care pediatricans in the evaluation of short and tall stature [Article in Bosnian]

Abstract

Monitoring the growth and development of children is the main task of preventive programs of pediatric health care. This is the best and simplest way of establishing the state of health of the child population, and at the same time, in the case of growth disorders, to make possible the timely application of possible preventive measures. For each child with short or tall stature in primary health care a detailed medical history should be taken, a physical examination undertaken using anthropological standards, assessment of bone maturation, calculation of genetic potential and basic laboratory tests. If there is a suspicion of normal variants of either short or tall stature, in order to establish a definite diagnosis the patient should be referred to a pediatric endocrinologist. Insofar as this suspicion is confirmed, the patient and his/ her parents should be acquainted with the nature of the disorder and given information on attaining the definitive height of the child. The growth of these children should be monitored up to the end of growth at least once a year. In patients whose body height is below the 3rd percentile, or above the 95th percentile, after excluding normal forms of short or tall stature, attention should be turned to discovering the pathological causes of short or tall stature. The examination of these children may be long, complex and expensive, but its needs to be done in stages, mainly in a specialized institution.