Growth Charts 101

By , May 4, 2010 5:29 pm

A 12-month old boy presented to a Paediatric Clinic with concerns regarding his growth.  Prior to arrival, the chart below was faxed through.

The following pattern is pathognomonic of a single disease process.  It is a spot diagnosis, but often missed by inexperienced clinicians:

The disease phenomenon is known as Shrinkingheaditis, eponymously named after Alfred Shrinkinghead, the great 19th Century English physician, who never owned a computer, most likely because they were yet to be invented.  All the same, he found buttons of any description very confusing.

To the untrained eye, the changes above may be missed.  Yet, if you examine the growth chart closely, you will find that the last three dots are below the two prior to that – an unusual finding for a skull, as it is made of bone.

Don’t despair if you miss it at first;  these changes are very subtle.  If you are having difficulty, you may need to squint, or even stare through it, like you would with one of those 3D drawings everyone loved in the 1990s.  Several readers have suggested swapping between internet browsers to appreciate the changes, which are often missed if only viewed through Internet Explorer.

This is a very serious condition.  Thankfully, this disease is reversible, and was discovered just in time.  Had Shrinkingheaditis continued for another few weeks, then the case would have become fulminant, the curve represented a parabola, and the child imploded and become a black hole.

Which would have been very embarrassing indeed.

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