First, you have to make sure that your baby is not really short. Nowadays, many parents like to compare horizontally with other children. Of course, it is good to have enough attention and vigilance, but one-sided horizontal comparison does not explain the problem. Many parents feel that their child is thin and short, but in fact, the child’s growth is completely within the normal level, height growth is more constrained by genetic influence, and weight is definitely not the higher the better. Therefore, parents can confirm which area their child is in according to the growth curve of Chinese children. If the weight and height are within the normal range and there is no unexplained growth retardation or stagnation in recent months, even if the child is in the lower region of the normal range, it does not mean in any way that the child has an abnormality. If the child is really short, then there are many causes. Before treatment doctors must find out the cause and make a clear diagnosis, and then consider how to treat it; only by prescribing the right medicine can we get good results. The diagnosis of a child with short stature relies first of all on a detailed medical history inquiry and physical examination. An experienced pediatric endocrinologist will have an initial impression of the cause based on the history and physical examination, and then select some laboratory or other tests to assist in the diagnosis as needed. There are two kinds of considerations for whether special tests are needed for the time being No laboratory tests are needed for the time being These children are in good general condition, have normal intelligence, their height is close to the lowest value of the normal standard (third percentile value), their growth rate is basically normal, and those who have the following conditions and are in a position to come for regular (3-6 months) outpatient review; the child’s parents are also short or have a history of delayed pubertal growth; the child is young and the parents are not The child’s parents are also short or have a history of delayed puberty. In these cases, we may not do the test for the time being, and we may follow up the child for six months to one year to observe the growth of height before making a decision. If the growth rate of height is lower than normal, such as below 4 cm/year, even if the height is within the normal range, laboratory tests should be done; if the patient comes from abroad, it is not easy to visit the clinic and it is not convenient to observe the height regularly. For this kind of children, the conditions of laboratory tests can be relaxed, even if their height is slightly higher than the third percentile, if the parents agree, laboratory tests can be done. What laboratory and imaging tests do pediatric endocrinologists usually perform on children with dwarfism? Routine blood and urine tests, liver and kidney functions, blood calcium, phosphorus and alkaline phosphatase, and X-ray plain radiographs of bone age are usually done. In addition, the following endocrine hormone tests and other tests are done as needed. 1. Thyroid function tests including thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH). If necessary, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-related antibodies may be added. To rule out thyroid diseases such as hypothyroidism, etc. There are many kinds of drugs used for growth hormone drug stimulation test, such as arginine, levodopa, colistin and insulin hypoglycemia, which are commonly used in clinical practice. Insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) can also be examined in hospitals with conditions. 3.Blood chromosomal examination For dwarf girls, except for “congenital ovarian hypoplasia”, also known as “Turner syndrome”, intravenous blood sampling (no fasting) is required for chromosomal examination. 4. Imaging tests such as magnetic resonance imaging (MRI) of the pituitary gland of the skull. In addition, pelvic ultrasound is required for girls with suspected Turner syndrome. 5. Other special tests related to dwarfism, etc. For growth monitoring, it is generally recommended to measure the child’s height and weight every 3-4 months, or at least once a year precisely, and to record and keep the measurement data and the time of measurement (accurate to the month, day and year) carefully. It is a good idea to also record the measurements on a growth chart. The child’s own growth curve is obtained by connecting the points traced several times. By comparing the child’s own growth curve with the standard curve of a normal child population, it is easy to determine visually whether the child’s height is developing normally. If the child’s curve continues along a grade line, it is healthy and normal. If the curve suddenly moves from one grade to a lower grade, it suggests that there are adverse factors interfering with the child’s growth. In addition, if estimated numerically, a child over the age of 3 years with less than 5 cm of height growth per year can be considered to have a growth retardation. For children with puberty, it can be combined with the degree of sexual development, bone age and other indicators to make a comprehensive judgment.