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Forum Name: Pediatric Topics

Question: 4 year old son is the size of 2 yr old with no bone age dela


 austinlogan - Wed Mar 12, 2008 2:40 pm

My son is almost 4 and is only 27 pounds and 33 inches tall. We had a bone age scan done when he was 3 yrs and 2 months old and the bone age was of a 2 year to 2 year 8 month old. in a year time frame he has only gained a pound and almost an inch. We did another bone age scan yesterday and it was bone age of a 3 yr 8 month old. He will be 4 in June. My ped. is having him tested for cystic fibrosis and going to an endocronologist. Im confused if I should be worried. I mean he is really really small. My two year old is bigger then him, it just seems like he never has a growth spurt. I thought that if it was a putuitary gland problem then he would have a bone age delay Im confused. I also don't understand why he is being tested for cystic fibrosis if he doesn't have symptoms of lungs problems. PLEASE HELP!!!!
 Dr. Chan Lowe - Thu Mar 13, 2008 10:58 pm

User avatar Hello Austinlogan,

Cystic fibrosis can present as "failure to thrive" (basically failure to grow) well before it begins to manifest with lung problems. I would agree with the sweat chloride test to evaluate for CF.

You are correct that generally problems with the pituitary (growth hormone, etc.) have a delayed bone age. The difficult part is that bone age x-rays give an age plus or minus several months. So if the bone age is read as 3 yrs 8 months with a span of 8 months his bone age may actually be more like 3 years which may be considered delayed in that age. Seeing the endocrinologist is important to help sort this out. It may be that your son should have a growth hormone stimulation test to see if he is making enough. The endocrinologist will help sort all this out for you.

Best wishes.
 austinlogan - Fri Mar 14, 2008 9:56 pm

Thankyou so much for your response! He got tested for CF today and it came back negative so we will be seeing a endocrinologist. with what I have told you would you think there is more of a chance of something wrong with his hormones, is there a possibility that he is just this small? If it is a hormone problem what kind of treament is given and will he live a normal life?

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