Overview Constitutional growth delay Introduction the most common cause of short stature and pubertal delay adolescents will have a normal growth spurt and normal adult height Presentation normal birth weight and height drop in percentiles on growth curve between 6 months and 3 years, re-establishment of normal growth velocity and following the growth curve at the 5th to 10th percentiles Evaluation characterized by a bone age that is less than chronological age login to view 1 more bullet TSH login to view 1 more bullet Treatment reassurance and regular follow-up Precocious puberty going through puberty at a younger age than is expected < 8 for girls, < 9 for boys if advanced bone age: Central: high FSH and LH login to view 2 more bullets Peripheral: low FSH and LH login to view 1 more bullet if normal bone age: isolated premature thelarche isolated premature adrenarche can occur secondary to obesity