Review Question - QID 109344

A 9-year-old girl presents to the pediatrician for short stature. The patient is in 3rd grade and is the shortest child in her class. She is otherwise doing well in school, and her teacher reports that she is at or above grade level in all subjects. The patient has many friends and plays well with her 2 younger siblings at home. She has a past medical history of mild hearing loss in her right ear, which her previous pediatrician attributed to recurrent bouts of otitis media when she was younger. The patient’s mother is 5 feet 6 inches tall and her father is 6 feet tall. Her family history is otherwise significant for hypothyroidism in her mother and hypertension in her father. The patient’s weight and height are in the 40th and 3rd percentile, respectively. Her temperature is 97.7°F (36.5°C), blood pressure is 155/94 mmHg, pulse is 67/min, and respirations are 14/min. On physical exam, the patient has a broad chest with widely spaced nipples. She is noted to have a short 4th metacarpal and moderate kyphosis. This patient is most likely to have which of the following findings on physical exam?