Paediatricsmiddle twist
A 7-year-old girl is brought because her school photograph shows her much shorter than her friends. At 4 years of age her height and weight were both on the 50th percentile; her height is now just below the 3rd percentile and her weight is on the 75th. Her mother says she is slow to get going in the mornings, her skin feels rough, and she opens her bowels twice a week. Her blood pressure is 95/58 mmHg and there are no abdominal striae. She is doing well at school. A wrist radiograph shows a bone age of 5 years. Which one of the following is the most likely diagnosis?