Review Question - QID 109483

A 15-year-old male presents to the pediatrician with his mother for evaluation of short stature. The patient feels self-conscious about his height and would like to know if there are any medications he can take to address his height. The patient otherwise feels well and has no complaints. The patient’s mother reports that the patient’s birth weight and height were in the 30th and 40th percentiles respectively and that both measurements dropped below the 5th percentile at 6 months of age. Since then, the patient has always been on the smaller size. He is several inches shorter than his brothers were at this age. The patient’s mother is 5’11” (180 cm), and the patient’s father is 5’10” (178 cm). His temperature is 98°F (36.7°C), pulse is 70/min, blood pressure is 118/77 mmHg, respirations are 13/min, and oxygen saturation is 98% on room air. On examination, the patient is 5’0” (152 cm) and weighs 43 kg (95 lb). Upon review of his growth chart, the patient’s height velocity is calculated as 5 cm/year. Bone age determination using a radiograph of the wrist, hand, and fingers demonstrate a bone age of 13 years of age. The patient’s growth chart can be seen in Figure A. Which of the following is the most appropriate next step in management?