Growth
Parameters of physical growth should be routinely measured on each visit and plotted on the standard growth chart. Height and weight are obtained at all ages, and head circumference is measured in children under three years and thereafter in children with deviations.
Serial monitoring is necessary in hydrocephalus, regardless of etiology, and microcephaly, which reflects defective brain growth. In spina bifida and other disabilities that require full-time wheelchair use, arm span measurement is recommended instead of height (7). Extremity length and girth are recorded in children with localized growth disturbance due to neurogenic weakness, epiphyseal fracture, or arthritis. In growth disturbances that involve one side of the body, one must determine whether the condition represents hemihypertrophy or hemiatrophy. Hemihypertrophy unrelated to neurologic causes requires investigation for renal tumor.
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