children s health issues
Delayed Puberty
Diagnosis of Delayed Puberty
A physical examination Bone age x-ray Blood tests Sometimes magnetic resonance imaging Genetic testing Pelvic ultrasonography (for girls) The initial evaluation of delayed puberty should consist of a complete history and physical examination to evaluate pubertal development, nutritional status, and growth. Doctors often take x-rays of one or more bones to see the level of bone maturity (called a bone age x-ray). Doctors take blood samples and do basic laboratory tests to look for signs of chronic disease, hormone level tests, and possibly genetic testing. Doctors usually evaluate boys who have no signs of puberty by age 13 or 14 years and girls who have no signs of puberty by age 12 or 13 years or who have not menstruated by age 15 years. If these children otherwise appear healthy, they most likely have constitutional delay. The doctor may decide to re-examine these adolescents at 6-month intervals to ensure that puberty begins and progresses normally. Girls with severely delayed puberty should be Evaluation . This evaluation includes an ultrasound of the pelvis and other blood and genetic tests. Magnetic Resonance Imaging (MRI) (MRI) may be done to ensure that there is no brain tumor or structural abnormality in the pituitary gland. 