Clinical Findings

  • Boys: no testicular enlargement (< 4 ml or < 2.5 cm) by 14 years of age
  • Girls: no breast development by 13 years of age or no menses by 15 years of age

Note: Girls with no menses by 15 years and notable short stature, consider Turner Syndrome.

Referral Timeframe

Routine

Pre-Referral Workup

  • Bone age
  • TSH and T4 or Free T4 by dialysis
  • Pediatric LH (CPL 2776, Esoterix 500234, Lab Corp 502286)
  • Pediatric FSH (CPL 2700, Esoterix 500192, LabCorp 502280)
  • Boys- Pediatric Testosterone (CPL 2833, Esoterix 500286, Lab Corp 500159)
  • Girls- Ultrasensitive Estradiol (CPL 5678, Esoterix 500152, Lab Corp 500108)
  • HIGH RESOLUTION Karyotype (if suspect Turner Syndrome)
  • Please get labs at 8am

Referral Requirements

  • Growth chart
  • Bone age results- Please have parent bring a copy of film/CD to appointment
  • Lab results
  • Relevant clinical notes with physical examination including Tanner stage