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