Growth rates and the prevalence and progression of scoliosis in short-statured children on Australian growth hormone treatment programmes

185 patients were recruited and a database incorporating the age at commencement, dose and frequency of growth hormone treatment and growth charts was compiled from their Medical Records. The presence of any known syndrome and the clinical presence of scoliosis were included for analysis. Subsequently, skeletally immature patients identified with scoliosis were followed up over a period of a minimum four years and the radiologic type, progression and severity (Cobb angle) of scoliosis were recorded.Four (3.6%) of the 109 with idiopathic short stature or hormone deficiency had idiopathic scoliosis (within normal limits for a control population) and scoliosis progression was not prospectively observed. 13 (28.8%) of 45 with Turner syndrome had scoliosis radiologically similar to idiopathic scoliosis. 11 (48%) of 23 with varying syndromes, had scoliosis. In the entire cohort, the growth rates of those with and without scoliosis were not statistically different and HGH treatment was not ceased because of progression of scoliosis.In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four). An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed.Research indicating that juveniles who develop idiopathic scoliosis have a markedly elevated growth rate compared to controls fostered a popular belief that growth hormone influences the progression of scoliosis[1,2]. Serum levels of growth hormone in children with idiopathic scoliosis were found to be elevated between the ages of seven and twelve years compared to controls [3-7]. Progression of structural scoliosis was reported in a short-statured patient during Human Growth Hormone (HGH) treatment [8] and stimulated a systematic clinical audit of children with scoliosis on an HGH treatment programme in one institution [9]. The administration of HGH