Table 9.

Assessment of suspected stunted growth

	Endpoints
1. Growth curve	Record the growth curve Check for short stature (SD, ≤ − 2.0) and a reduced growth rate (growth rate SD, ≤ − 1.5)
2. Medical history and family history	Evaluate the patient’s history (including small-for-gestational-age status), general condition, chromosomal abnormalities, signs of malformations, and limb balance Evaluate the family history and heights of the parents
3. Blood and bone age tests	Blood test: evaluate anemia, liver function, kidney function, inflammation, thyroid function, gonadal function, bone system disease, and adrenocortical function Bone age test: perform an X-ray examination of the left hand to evaluate the radius, ulna, and phalanges of the left hand, including the epiphyseal cartilage and carpal bones
4. Growth hormone challenge	Evaluate the growth hormone and sex hormone secretion capacities (pediatric endocrinologist)

SD standard deviation