Children with dwarfism and precocious puberty must choose a regular hospital with a physician specializing in pediatric endocrinology or a specialist in dwarfism and precocious puberty for a systematic endocrine examination of the child. Because this is a very specialized branch of pediatrics, do not think that it is enough to find a random doctor, otherwise you will waste a lot of time and money and delay the treatment. Parents of children with dwarfism and precocious puberty need to explain to the attending doctor the following information in detail: 1. 4. the child’s diet, sleep, exercise, intelligence, history of hepatitis, nephritis, traumatic brain injury and other special medical history, and whether the child has used drugs and health care products that affect growth and development; 5. the parents’ height, history of early or late development and the height of other members of the family; 6. family history of tumors, diabetes, genetic diseases, etc.; 7. previous medical consultations 7. the results of relevant tests and treatment, etc. (bring the child’s case and the results of previous tests). The causes of dwarfism are complex, and to find out the cause, we must first analyze the causes of dwarfism through medical history, physical examination, and laboratory results, and finally determine the treatment plan. First of all, we need to take orthopantomogram of the left wrist (bone age film) to understand the bone age, determine the growth of the child’s bones, the degree of epiphyseal closure (if the epiphysis is closed, there is no possibility of treatment) and the growth potential. 2. Liver and kidney function, blood glucose, hepatitis B and half, routine blood, urine and thyroid hormone, and growth hormone stimulation test should be done to understand the growth hormone level, insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein (IGFBP-3). In girls, chromosomes are also checked to rule out “congenital ovarian hypoplasia (Turner’s syndrome)”, and in a very small number of boys, chromosomes may also be checked. A magnetic resonance imaging (MRI) of the pituitary gland is usually needed to understand the development of the pituitary gland and to rule out pituitary tumors. What tests are needed for children with precocious puberty? 1. First, a detailed assessment of bone age and prediction of adult height is also needed. Secondly, sex hormone levels should be checked (generally six sex hormones, including at least FSH, LH and E2), and ultrasound examination, uterus, ovaries, follicle size (or testicular size in boys) to determine sexual development. 3.It is also necessary to check adrenal function or ultrasound (to exclude precocious puberty caused by adrenal cortical hyperplasia or tumor, etc. The adrenal glands can also secrete sex hormones), and thyroxine level; especially for those who suspect central precocious puberty, pituitary magnetic resonance imaging (MRI) is needed, and some children with precocious puberty also need to check alpha-fetoprotein (AFP) and chorionic gonadotropin (HCG) to exclude germ cell tumor, etc. 4.For those who consider the possibility of true (central) precocious puberty, especially those who need to consider GnRHa (gonadotropin releasing hormone analog) treatment, GnRH (gonadotropin releasing hormone) excitation test (can be referred to as sex hormone excitation test or LHRH excitation test) is needed to clarify whether it is true precocious puberty.