Bone Age Scan/Endocrinologist

[Jjhernandez]

Anonymous wrote:What do you mean he isn't growing normally?

The bone age and DHEA-S numbers are a range. His seem within normal range. Is there something else that made her order the test?

He is in like the 3rd percentile for height and that is not aligned with our heights. That is why she started digging deeper.

[Anonymous]

Your pediatrician sounds like she's not that good. The bone age being young sounds in line with the growth delay. Your child's predicted height may still be in line with the mid-parental height even if he's at 3rd percentile right now because his growth is just happening at a later time than his actual age.

Still worth it to see the endocrinologist to get more information but it doesn't sound really worrisome to me.

[Anonymous]

Check out children’s hospital. My sister’s son has been going through numerous tests on exact same issues.

Few things to consider:

she had kid go on strict gf/non dairy/low sugar diet bc being small with slow bone growth got him bullied and he acted out. Eliminating red dye and other non-helpful sugar stuff (he still eats this stuff but did elimination diet to see what triggered things for him) seemed to help him.

Also vitamin and mineral absorption may be an issue.

In addition, multiple Covid infections may also mess up inflammation and body’s response in weird ways. If that might be case check out Mayo Clinic. They have tremendous research, studies and resources. Also check out the health blog on this site. It’s good.

For my sister, it’s a lot of tests and unknowns and going to children’s hospital was excellent in having a specific children’s endocrinologist to guide her through this journey. You need a specialist for children. She’s done all day blood draws for hormone level measurements etc. John’s Hopkins has excellent children specialist but growth hormones need to be used before puberty. Might be too late. But may help. Talk to a specialist.

Good luck and wishing you best. It’s especially hard for boys as there’s a societal expectation on height that puts them feeling self conscious.

And you’re a great mom just in case no one has told you that. It’s important to know that you are doing good things by getting this checked out and taking time to figure this out. You got this, mama!!!!

[Anonymous]

Jjhernandez wrote:

Anonymous wrote:What do you mean he isn't growing normally?

The bone age and DHEA-S numbers are a range. His seem within normal range. Is there something else that made her order the test?

He is in like the 3rd percentile for height and that is not aligned with our heights. That is why she started digging deeper.

Yes that’s good to check out. Reasonable to seek more info. That’s very low percentile.

[Anonymous]

OP (edited for updates):

OP, I know I am late but here goes:

DS(now 20) wasn't growing like his friends, no puberty, no voice drop, etc. but his pediatrician showed his growth curve was consistent

At 16 when things flattened slightly the pediatrician sent us for a wrist X-ray, which showed his bones were that of a 13yo. And he was shorter than me; I am 5'5"

We saw an endocrinologist at UVa who disappointed DS when he said DS was still in the range of normal growth. I honestly think DS thought he would get a shot at the appointment and grow overnight. God love him.

That was 2 weeks before 03/13/2020.

He proceeded to grow and grow while in lockdown/virtual school/whatever.

When school started in person he was nearly 6 ft tall. He's now 6'2" and we "think" he's almost done.

He's still not hairy person with a deep voice. This tracks with others on both sides of the family. *This remains true

His younger brother OTOH is hairy, smelly, deep voice, etc. *This remains true

Different paths.

[Anonymous]

I agree with others to have a pediatric endocrinologist that a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still have more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but efinitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

[Anonymous]

Anonymous wrote:I agree with others to have a pediatric endocrinologist take a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still has more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but definitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

Same poster. Sorry for the typos.

[Anonymous]

Anonymous wrote:I agree with others to have a pediatric endocrinologist that a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still have more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but efinitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

+1

Delayed bone age is a positive.

This was our experience as well. My DS has about a 2yr delay. He dropped very low in height percentiles ages 13-14 (barely grew at all those years- I think it was 3 inches total in 2yrs), and started his growth spurt at 15 (grew 5 inches from 15-16). But everything was consistent and the data made sense according to the endocrinologist (his bone age, Tanner stage etc). In my DS’s case it was simply delayed puberty. Also- many kids have a growth plateau right before growth spurt. For my DS that occurred during the time that peers were hitting a growth spurt, amplifying the differences which caused the enormous drop in height percentiles.

[Anonymous]

Anonymous wrote:I agree with others to have a pediatric endocrinologist that a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still have more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but efinitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

With my son yes he has the delayed bone age, but he is puberty. That is what was concerning to the pediatrician and she said it could represent a growth problem.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I agree with others to have a pediatric endocrinologist that a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still have more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but efinitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

With my son yes he has the delayed bone age, but he is puberty. That is what was concerning to the pediatrician and she said it could represent a growth problem.

Puberty doesn’t happen at a single moment in time. It happens over several years. Delayed puberty just means he’s a late bloomer - i.e, started puberty later than usual, in the early stage of puberty longer than peers, etc. So your son can be in puberty and still be diagnosed with delayed puberty. For example, DS is 16 and still in Tanner stage 3 while many of his peers are almost done with puberty.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I agree with others to have a pediatric endocrinologist that a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still have more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but efinitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

With my son yes he has the delayed bone age, but he is puberty. That is what was concerning to the pediatrician and she said it could represent a growth problem.

Puberty doesn’t happen at a single moment in time. It happens over several years. Delayed puberty just means he’s a late bloomer - i.e, started puberty later than usual, in the early stage of puberty longer than peers, etc. So your son can be in puberty and still be diagnosed with delayed puberty. For example, DS is 16 and still in Tanner stage 3 while many of his peers are almost done with puberty.

But definitely get a consultation with a pediatric endocrinologist!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I agree with others to have a pediatric endocrinologist that a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still have more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but efinitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

With my son yes he has the delayed bone age, but he is puberty. That is what was concerning to the pediatrician and she said it could represent a growth problem.

Puberty doesn’t happen at a single moment in time. It happens over several years. Delayed puberty just means he’s a late bloomer - i.e, started puberty later than usual, in the early stage of puberty longer than peers, etc. So your son can be in puberty and still be diagnosed with delayed puberty. For example, DS is 16 and still in Tanner stage 3 while many of his peers are almost done with puberty.

This makes me feel better and is good to know. I know the ped doc doesn't know as much about this stuff, so I am trying to be patient and wait for our appt. We go Wednesday to the endo doc, so I will update on here as well with what is said.

[Anonymous]

Just curious as my son is the same age and showing no signs of puberty and has tiny feet. We can't tell if he's destined to be really short or if he's a late grower. What size shoes does your son wear and how tall is he?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I agree with others to have a pediatric endocrinologist that a look at the bone age scan. If your child is small and showing delayed bone age, that is a GOOD sign as it means he still have more room to grow.

My DS was referred to a PE last year because he fell to <10th percentile in height and was showing no signs of puberty. His bone age study showed that he was ~2.5 years behind in bone age. DS has grown steadily over the past year and, at 16, is up around 25th percentile but bone age is still showing ~3 years delay, which means he still has a lot of growth left. He just might not reach his full growth potential until he's in college, similar to the PP's son.

That said, his bloodwork always showed low testosterone levels, which were consistent with where he was in puberty so I would definitely ask about that. If it's high, it may mean he's about to hit a growth spurt but efinitely check with a PE as they will be able to run other tests to see what Tanner Stage he is in.

With my son yes he has the delayed bone age, but he is puberty. That is what was concerning to the pediatrician and she said it could represent a growth problem.

Puberty doesn’t happen at a single moment in time. It happens over several years. Delayed puberty just means he’s a late bloomer - i.e, started puberty later than usual, in the early stage of puberty longer than peers, etc. So your son can be in puberty and still be diagnosed with delayed puberty. For example, DS is 16 and still in Tanner stage 3 while many of his peers are almost done with puberty.

+1

My DS is on a similar timetable with late puberty. Also OP- the growth spurt doesn’t usually happen the moment boys hit puberty- it usually occurs towards the middle/toward the end of puberty. And it can vary a lot. A boy can absolutely be in puberty yet no growth spurt yet- that is actually pretty normal. If you Google typical Tanner Stages for boys you can see the estimates timetable. But growth patterns still vary a ton, even within those parameters.

[Anonymous]

Hair isn't reliable. My kids had hair in pits and pubes in 5th/6th grade and didn't hit their growth spurts until 10th grade (the first one). Another one around 17-18.

My oldest was 5'5" in 9th and graduated at 6" and expected to grow 1-2 more inches (typical of men in our family).

My other son was 5'4" in 9th and very, very skinny, baby face. He is now 5'8" end of sophomore year/16. Voice hasn't changed. Very hairy legs/pits--not on his face, little to no facial hair--hasn't filled out...long limbs--his growth plates are still wide open on x-ray for a sports injury.

Kids don't all follow the 'signs of puberty'/Tanner in the same model/manner.