Growth chart of a boy with constitutional growth delay.
The boy's short height during childhood would have been accompanied by a delayed bone age. When the average boys of his age started to grow rapidly in puberty, this boy was left behind. Thus, he was referred for short stature and delayed puberty. His pubertal stages were appropriate for his bone age and, due to previously normal growth velocity, a normal growth spurt in puberty was predicted and occurred as shown. It is difficult to determine whether there is a minor degree of GH deficiency if adequate previous growth records are not available.
