Table 1 Proposed model of assessment and management for girls with Turner syndrome from infancy to 18 years.

Measurements and investigations	Treatment
4–6 monthly	Growth hormone
Height and weight	Age at start
Blood pressure	When height falls <−2 SD on a standard growth chart or
Pubertal staging (from 10 years onwards)	When the family identifies short stature as becoming a problem or
	By 8 years of age
12–18 monthly	Dose: 10 mg/m2/week (≈0.3 mg/kg/week) by daily injection
Thyroid function and IGF‐1 measurement
Bone age
Hearing assessment
3–5 yearly	Oestrogen for pubertal induction*
DXA scan for bone density	Age at start: 13 years, unless GH started particularly late and in the absence of any patient/family preference for earlier or later
Other assessments	Dose: Protocol adopted by UK Turner Study (see text for details):
FSH levels and pelvic ultrasound scan prior to pubertal induction	Year 1: Ethinyloestradiol 2 μg daily
Liver function tests, prior to (a) pubertal induction and (b) adult transfer	Year 2: Ethinyloestradiol 4 μg daily
Renal imaging Ultrasound scan at diagnosis and at adult transfer. Additional imaging if indicated (e.g. ultrasound abnormal ± recurrent UTI)	Year 3: Ethinyloestradiol 6 μg daily, increasing every 4 months to 8 μg and then 10 μg daily Year 4: Adult replacement dose
Cardiac assessment
Ultrasound scan at diagnosis, at pubertal induction, and at adult transfer
Eye assessment at diagnosis, follow up as required	Norethisterone 5 mg daily for the first 5 days of each calendar month when ethinyloestradiol reaches 10 μg daily, or when breakthrough bleeding occurs, whichever is the sooner
Referral as required	Oxandrolone*
ENT/Audiology	Age at start: from 9 years of age
Podiatrist	Dose: 0.05 mg/kg/day, maximum 2.5 mg/day
Dietician
Dermatologist
Psychologist
Ophthalmology

*Currently under investigation in the UK Turner Study.