Symptoms of restricted growth

People with restricted growth (dwarfism)often have no symptoms other than short stature, although some people have associated health problems.

Symptoms commonly seen in people with proportionate and disproportionate short stature are outlined below.

Proportionate short stature

People with proportionate short stature (PSS)grow very slowly and have a general lack of growth throughout the body. The length of the trunk (tummy and chest) remains in normal proportion with the legs.

PSS may not be noticeable until later in childhood or until a child reaches puberty.

Additional symptoms associated with PSS depend on the underlying cause. For example:

• people with growth hormone deficiency may havelow energy levels, increased body fat, weak bones ( Osteoporosis ), dry skin, reduced muscle strength and high cholesterol
• girls and women with Turner syndrome won't start having periods and won't be able to have children
• people with Prader-Willi syndrome may havea constant desire to eat, reduced muscle tone ( hypotonia ), learning difficulties and behavioural problems
• people with chronic illnesses affecting organs such aslungs, heart or kidneys will have further symptoms relating to their underlying condition

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Disproportionate short stature

In peoplewith disproportionate short stature (DSS), there is an overall lack of growth, andcertain limbs may be shorter or out of proportion with otherparts of the body.

People withachondroplasia, one of the most common causes of DSS, typicallyhave:

• a normal-length trunk with short arms and legs
• a large head with a prominent forehead and flat nasal bridge
• short and wide hands and feet
• short fingers and toes

Most people with DSS don't have any other significant health problems, although some people withachondroplasia have:

• bowed legs, which may cause ankle or kneepain
• abnormal curvature in the top of the spine ( kyphosis ) and/or sideways curvature of the spine ( scoliosis )
• a build-up of fluid around the brain ( hydrocephalus )
• repeated middle ear infections , which can cause hearing difficulties
• irregular breathing at night ( sleep apnoea ), which can interrupt sleep and cause excessive sleepiness during the day
• numbness and weakness in the legs, caused by the compression ofthe spinal cord and nerves leaving the spine