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Constitutional delay of growth and puberty — MRCPCH FOP MCQ

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ModerateEndocrinology and growthConstitutional delay of growth and pubertyMRCPCH FOP

A 14-year-old boy has short stature and no pubertal signs. He is otherwise well, has normal examination, delayed bone age and his father reports late puberty. What is the most likely diagnosis?

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Correct answer: D — Constitutional delay of growth and puberty

A well adolescent boy with delayed bone age and family history of late puberty most likely has constitutional delay. Klinefelter syndrome may present with delayed puberty but often has small firm testes and tall stature. Congenital adrenal hyperplasia would usually cause androgen excess rather than delayed puberty in this pattern. The pearl is that bone age gives useful context for growth potential.

Reference: RCPCH growth charts; BSPED delayed puberty guidance