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