Growth disorders

​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Myxoedema coma
  • Suspected adrenal crisis or first diagnosis of adrenal insufficiency, including unexplained hyponatraemia and hypoglycaemia
  • Suspected pituitary mass (e.g. symptoms of visual field loss or central nervous system signs)
    Note: refer to pituitary disorders paediatric state-wide referral criteria

When public outpatient services are not routinely provided

  • Height > 1st percentile with normal growth (i.e. growth in line with familial potential or normal growth velocity over
     6-12 months)
  • Simple obesity (BMI ≥ 95th percentile for age and sex)​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.

  • Hypoglycaemia
  • Pubertal arrest
  • Untreated hypothyroidism​
Category 2
Recommended to be seen within 90 calendar days.
  • ​​Constitutional delay of growth and puberty
  • Cushing's syndrome
  • Delayed puberty in females aged > 13 years
  • Delayed puberty in males aged > 14 years
  • Documented centile crossing due to poor height velocity
  • Primary or secondary amenorrhoea
  • Short stature with slow growth and relative obesity
  • Skeletal dysplasia
  • Small for gestational age with no catch-up growth in the first 2 years
  • Syndrome associated short stature​

Category 3
Recommended to be seen within 365 calendar days.

  • Variants of normal growth (including familial short stature)​

Information to include within a referral

Required​

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Height and weight centiles
    • Serial measurements from Blue Book and/or previous clinic visits
    • Detailed history (personal, family and social)
    • Treatments offered and efficacy
    • Physical examination (including signs of neglect or abuse)
    • Assessment of psychosocial deprivation
    • Development assessment
    • Feeding history​​

If available​​

  • Parental height
  • Full blood count (FBC)
  • Erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • Electrolytes, Urea, Creatinine (EUC)
  • Bone chemistry (calcium, phosphate and alkaline phosphatase)
  • Coeliac serology (TTG and IgA)
  • Karyotype or single nucleotide polymorphism (SNP) array in females (to exclude Turner syndrome)
  • Thyroid stimulating hormone (TSH)
  • Free thyroxine (fT4)
  • Free triiodothyronine (fT3)
  • Insulin-like growth factor (IGF-1)
  • Follicle stimulating hormone (FSH) in females aged < 2 years or aged > 9 years
  • Urine protein and blood​​

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team. 

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing