In assessing all short patients, a detailed history, physical examination, and urine analysis are required, together with a radiograph of the non dominant hand and wrist, allowing the bone age to be assessed and hence also the growth potential. Short stature that is out of keeping with the family background is likely to be significant. The mid parental height (the mean of the parental centile heights) can be calculated in order to estimate height expectation. Information should also be obtained about the growth pattern in the parents, especially concerning the time of onset of the pubertal growth spurt.