Official dwarf height

Official dwarf height DEFAULT

Overview - Restricted growth (dwarfism)

Restricted growth, sometimes known as dwarfism, is a condition characterised by unusually short height.

There are 2 main types of restricted growth:

  • proportionate short stature (PSS) – a general lack of growth in the body, arms and legs
  • disproportionate short stature (DSS) – where the arms and legs are particularly short

As well as being short, some people with restricted growth also have other physical problems, such as bowed legs or an unusually curved spine.

But most people don't have any other serious problems and are able to live a relatively normal life, with a normal life expectancy.

Read more about the symptoms of restricted growth.

What causes restricted growth?

Causes of PSS

The most common cause of PSS is being born to small parents, but it's sometimes the result of the body not producing enough growth hormone.

Certain genetic syndromes, such as Turner syndrome, Noonan syndrome and Prader-Willi syndrome, can also cause PSS.

Causes of DSS

A rare genetic condition called achondroplasia is the most common cause of DSS.

It causes poor bone growth, resulting in short upper arms and thighs.

It doesn't always run in the family – many children with achondroplasia have parents of normal height.

The Restricted Growth Association UK has more information about achondroplasia and other rare types of restricted growth.

Diagnosing restricted growth

Restricted growth may be diagnosed before a child is born, soon afterwards, or when growth problems become more obvious as they get older.

Growth hormone deficiency is usually diagnosed using growth hormone stimulation tests.

Medicine is injected into a vein or muscle to cause an increase in growth hormone levels in the blood. A lower than normal level indicates a deficiency in growth hormone.

A brain scan will be needed to look at the pituitary gland (which produces growth hormone) if blood tests show low levels of growth hormone.

If one or both parents have a family history of a condition that causes short stature, their baby can be tested for this during pregnancy (prenatal diagnosis).

Read more about screening tests in pregnancy.

Treatment for restricted growth

Treatment with growth hormone injections may benefit some people with restricted growth and can help a child with the condition grow more than they otherwise would.

In cases of DSS where the legs are particularly short, a leg-lengthening procedure is sometimes used, but there's some uncertainty about its safety and effectiveness.

Read more about treatments for restricted growth.

Page last reviewed: 30 March 2021
Next review due: 30 March 2024

Sours: https://www.nhs.uk/conditions/restricted-growth/

Dwarfism

Dwarfism is a medical or genetic condition that usually results in an adult height of 4'10" or shorter, among both men and women, although in some cases a person with a dwarfing condition may be slightly taller than that. The average height of an adult with dwarfism is 4’0, but typical heights range from 2’8 to 4’8.

Common Types of Dwarfism

The most frequently diagnosed cause of short stature is achondroplasia, a genetic condition that results in disproportionately short arms and legs. The average height of adults with achondroplasia is 4'0". Other relatively common genetic conditions that result in disproportionate short stature include spondyloepiphyseal dysplasia congenita (SEDc), diastrophic dysplasia, pseudoachondroplasia, hypochondroplasia, and osteogenesis imperfecta (OI). As one might expect from their names, pseudoachondroplasia and hypochondroplasia are conditions that have been confused with achondroplasia; diastrophic dysplasia occasionally is, too. OI is characterized by fragile bones that fracture easily.

The frequency of occurrence of the most common types of dwarfism (Greenberg Center at Johns Hopkins Medical Center, Lee Kitchens):

  1. Achondroplasia (one per 26,000 to 40,000 births)

  2. SEDc (one per 95,000 births)

  3. Diastrophic dysplasia (one per 110,000 births)

Proportionate dwarfism -- short-stature conditions that result in the arms, legs, trunk, and head being in the same proportion (relative size to one another) as in an average-size person -- is often the result of a hormonal deficiency, and may be treated medically, resulting in an average or near average height. There are not such treatments available for people with disproportionate short stature.

Although achondroplasia accounts for perhaps 70 percent of all cases of dwarfism, there are over 200 diagnosed types, and there are some individuals with dwarfism who never receive a definitive diagnosis and/or have a condition that is unique to themselves or their family.

Other Facts

  • There are over 200 distinct types of dwarfism. The most common type is achondroplasia.
  • Over 80% of people with dwarfism have average height parents, siblings and children.
  • It is very rare to have any type of mental impairment with dwarfism.
  • Preferred terminology for someone with dwarfism is "short stature," "having dwarfism," "little person," or "dwarf." The term "midget" is antiquated, and can be perceived by some as a rude slang word.
  • People with dwarfism are able to do everything an average-height person can - they can ride bikes, play sports, drive cars, travel, have fulfilling careers and families; they just may need a stool or a simple accommodation.

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Dwarfism

Small size of an organism, caused by growth deficiency or genetic mutations

This article is about the medical condition. For the legendary creature, see Dwarf (mythology). For other uses, see Dwarf.

Medical condition

Dwarfism occurs when an organism is exceptionally small.[1] In humans, it is sometimes defined as an adult height of less than 147 centimetres (4 ft 10 in), regardless of sex; the average adult height among people with dwarfism is 122 centimetres (4 ft 0 in), although some individuals with dwarfism are slightly taller.[2][3][4]Disproportionate dwarfism is characterized by either short limbs or a short torso. In cases of proportionate dwarfism, both the limbs and torso are unusually small. Intelligence is usually normal, and most have a nearly normal life expectancy.[5][6] People with dwarfism can usually bear children, although there are additionalrisks to mother and child, dependent upon the underlying condition.

The most common and recognisable form of dwarfism in humans (comprising 70% of cases) is the genetic disorderachondroplasia, whereby the limbs are diminutive.[7]Growth hormone deficiency is responsible for most other cases.[8] Treatment depends on the underlying cause. Those with genetic disorders can sometimes be treated with surgery or physical therapy. Hormone disorders can also be treated with growth hormone therapy before the child's growth plates fuse. Individual accommodations, such as specialized furniture, are often used by people with dwarfism.[9] Many support groups provide services to aid individuals and the discrimination they may face.[10]

In addition to the medical aspect of the condition, there are also social aspects. For a person with dwarfism, height discrimination can lead to ridicule in childhood and discrimination in adulthood.[11][12] In the United Kingdom, United States, Canada, Australia, and other English-speaking countries, labels that some people with dwarfism accept include dwarf (plural: dwarfs), little person (LP), or person of short stature (See Terminology).[13][14] Historically, the term "midget" was used to describe dwarfs (primarily proportionate); however, this term is now often regarded as offensive.[15]

Signs and symptoms[edit]

Dwarfism occurs in animals as well as humans; horses can have achondroplasticsymptoms, as shown here next to a person with dwarfism.

A defining characteristic of dwarfism is an adult height less than the 2.3rd percentile of the CDC standard growth charts.[16] There is a wide range of physical characteristics. Variations in individuals are identified by diagnosing and monitoring the underlying disorders. There may not be any complications outside adapting to their size.

Short stature is a common replacement of the term 'dwarfism', especially in a medical context. Short stature is clinically defined as a height within the lowest 2.3% of those in the general population. However, those with mild skeletal dysplasias may not be affected by dwarfism. In some cases of untreated hypochondroplasia, males grow up to 165 cm (5 feet 5 inches). Though that is short in a relative context, it does not fall into the extreme ranges of the growth charts.

Disproportionate dwarfism is characterized by shortened limbs or a shortened torso. In achondroplasia one has an average-sized trunk with short limbs and a larger forehead.[17] Facial features are often affected and individual body parts may have problems associated with them. Spinal stenosis, ear infection, and hydrocephalus are common. In case of spinal dysostosis, one has a small trunk, with average-sized limbs.

Proportionate dwarfism is marked by a short torso with short limbs,[4] thus leading to a height that is significantly below average. There may be long periods without any significant growth. Sexual development is often delayed or impaired into adulthood. This dwarfism type is caused by an endocrine disorder and not a skeletal dysplasia.

Physical effects of malformed bones vary according to the specific disease. Many involve joint pain caused by abnormal bone alignment, or from nerve compression.[13] Early degenerative joint disease, exaggerated lordosis or scoliosis, and constriction of spinal cord or nerve roots can cause pain and disability.[18] Reduced thoracic size can restrict lung growth and reduce pulmonary function. Some forms of dwarfism are associated with disordered function of other organs, such as the brain or liver, sometimes severely enough to be more of an impairment than the unusual bone growth.[19][20]

Mental effects also vary according to the specific underlying syndrome. In most cases of skeletal dysplasia, such as achondroplasia, mental function is not impaired.[4] However, there are syndromes which can affect the cranial structure and growth of the brain, severely impairing mental capacity. Unless the brain is directly affected by the underlying disorder, there is little to no chance of mental impairment that can be attributed to dwarfism.[21]

The psycho-social limitations of society may be more disabling than the physical symptoms, especially in childhood and adolescence, but people with dwarfism vary greatly in the degree to which social participation and emotional health are affected.

  • Social prejudice against extreme shortness may reduce social and marital opportunities.[22][23]

    See also: Heightism

  • Numerous studies have demonstrated reduced employment opportunities. Severe shortness is associated with lower income.[23]
  • Self-esteem may suffer and family relationships may be affected.
  • Extreme shortness (in the 60–90 cm or 2–3 feet range) can, if not accommodated for, interfere with activities of daily living, like driving or using countertops built for taller people. Other common attributes of dwarfism such as bowed knees and unusually short fingers can lead to back problems and difficulty in walking and handling objects.
  • Children with dwarfism are particularly vulnerable to teasing and ridicule from classmates. Because dwarfism is relatively uncommon, children may feel isolated from their peers.[19]

Causes[edit]

Dwarfism can result from many medical conditions, each with its own separate symptoms and causes. Extreme shortness in humans with proportional body parts usually has a hormonal cause, such as growth-hormone deficiency, once called pituitary dwarfism.[13][17] Achondroplasia is responsible for the majority of human dwarfism cases, followed by spondyloepiphyseal dysplasia and diastrophic dysplasia.[8]

Achondroplasia[edit]

Further information: Achondroplasia

The most recognizable and most common form of dwarfism in humans is achondroplasia, which accounts for 70% of dwarfism cases, and occurs in 4 to 15 out of 100,000 live births.[7]

It produces rhizomelic short limbs, increased spinal curvature, and distortion of skull growth. In achondroplasia the body's limbs are proportionately shorter than the trunk (abdominal area), with a larger head than average and characteristic facial features. Achondroplasia is an autosomal dominant disorder caused by the presence of a faulty allele in the genome. If a pair of achondroplasia alleles are present, the result is fatal. Achondroplasia is a mutation in the fibroblast growth factor receptor 3.[25] In the context of achondroplasia, this mutation causes FGFR3 to become constitutively active, inhibiting bone growth.[26]

Growth hormone deficiency[edit]

Further information: Growth hormone deficiency

Growth hormone deficiency (GHD) is a medical condition in which the body produces insufficient growth hormone. Growth hormone, also called somatotropin, is a polypeptidehormone which stimulates growth and cell reproduction. If this hormone is lacking, stunted or even halted growth may become apparent. Children with this disorder may grow slowly and puberty may be delayed by several years or indefinitely. Growth hormone deficiency has no single definite cause. It can be caused by mutations of specific genes, damage to the pituitary gland, Turner's syndrome, poor nutrition,[27] or even stress (leading to psychogenic dwarfism). Laron syndrome (growth hormone insensitivity) is another cause. Those with growth hormone issues tend to be proportionate.

Other[edit]

Other causes of dwarfism are spondyloepiphyseal dysplasia congenita, diastrophic dysplasia, pseudoachondroplasia, hypochondroplasia, Noonan syndrome, primordial dwarfism, Cockayne syndrome, Turner syndrome, osteogenesis imperfecta (OI), and hypothyroidism. Severe shortness with skeletal distortion also occurs in several of the Mucopolysaccharidoses and other storage disorders.[28] Hypogonadotropic hypogonadism may cause proportionate, yet temporary, dwarfism. NPR2 disproportionate dwarfism was discovered recently and is caused by a mutant gene.[29]

Serious chronic illnesses may produce dwarfism as a side effect. Harsh environmental conditions, such as malnutrition, may also produce dwarfism. These types of dwarfism are indirect consequences of the generally unhealthy or malnourished condition of the individual, and not of any specific disease. The dwarfism often takes the form of simple short stature, without any deformities, thus leading to proportionate dwarfism. In societies where poor nutrition is widespread, the average height of the population may be reduced below its genetic potential by the lack of proper nutrition. Sometimes there is no definitive cause of short stature.[citation needed]

Diagnosis[edit]

Dwarfism is often diagnosed in childhood on the basis of visible symptoms. A physical examination can usually suffice to diagnose certain types of dwarfism, but genetic testing and diagnostic imaging may be used to determine the exact condition.[30] In a person's youth, growth charts that track height can be used to diagnose subtle forms of dwarfism that have no other striking physical characteristics.[8]

Short stature or stunted growth during youth is usually what brings the condition to medical attention. Skeletal dysplasia is usually suspected because of obvious physical features (e.g., unusual configuration of face or shape of skull), because of an obviously affected parent, or because body measurements (arm span, upper to lower segment ratio) indicate disproportion.[30] Bone X-rays are often key to diagnosing a specific skeletal dysplasia, but are not the sole diagnostic tool. Most children with suspected skeletal dysplasias are referred to a genetics clinic for diagnostic confirmation and genetic counseling. Since about the year 2000, genetic tests for some of the specific disorders have become available.[31]

During an initial medical evaluation of shortness, the absence of disproportion and other clues listed above usually indicates causes other than bone dysplasias.

Classification[edit]

In men and women, the sole requirement for being considered a dwarf is having an adult height under 147 cm (4 ft 10 in) and it is almost always sub-classified with respect to the underlying condition that is the cause of the short stature. Dwarfism is usually caused by a genetic variant; achondroplasia is caused by a mutation on chromosome 4. If dwarfism is caused by a medical disorder, the person is referred to by the underlying diagnosed disorder. Disorders causing dwarfism are often classified by proportionality. Disproportionate dwarfism describes disorders that cause unusual proportions of the body parts, while proportionate dwarfism results in a generally uniform stunting of the body.

Disorders that cause dwarfism may be classified according to one of hundreds of names, which are usually permutations of the following roots:

  • location
    • rhizomelic = root, i.e., bones of the upper arm or thigh
    • mesomelic = middle, i.e., bones of the forearm or lower leg
    • acromelic = end, i.e., bones of hands and feet.
    • micromelic = entire limbs are shortened
  • source
    • chondro = of cartilage
    • osteo = of bone
    • spondylo = of the vertebrae
    • plasia = form
    • trophy = growth

Examples include achondroplasia and chondrodystrophy.

Prevention[edit]

Many types of dwarfism are currently impossible to prevent because they are genetically caused. Genetic conditions that cause dwarfism may be identified with genetic testing, by screening for the specific variations that result in the condition. However, due to the number of causes of dwarfism, it may be impossible to determine definitively if a child will be born with dwarfism.

Dwarfism resulting from malnutrition or a hormonal abnormality may be treated with an appropriate diet or hormonal therapy. Growth hormone deficiency may be remedied via injections of human growth hormone (HGH) during early life.[32]

Management[edit]

Genetic mutations of most forms of dwarfism caused by bone dysplasia cannot be altered yet, so therapeutic interventions are typically aimed at preventing or reducing pain or physical disability, increasing adult height, or mitigating psychosocial stresses and enhancing social adaptation.[10]

Forms of dwarfism associated with the endocrine system may be treated using hormonal therapy. If the cause is prepubescent hyposecretion of growth hormone, supplemental growth hormone may correct the abnormality. If the receptor for growth hormone is itself affected, the condition may prove harder to treat. Hypothyroidism is another possible cause of dwarfism that can be treated through hormonal therapy. Injections of thyroid hormone can mitigate the effects of the condition, but lack of proportion may be permanent.

Pain and disability may be ameliorated by physical therapy, braces or other orthotic devices, or by surgical procedures.[10] The only simple interventions that increase perceived adult height are dress enhancements, such as shoe lifts or hairstyle. Growth hormone is rarely used for shortness caused by bone dysplasias, since the height benefit is typically small (less than 5 cm [2 in]) and the cost high.[9] The most effective means of increasing adult height by several inches is distraction osteogenesis, though availability is limited and the cost is high in terms of money, discomfort, and disruption of life. Most people with dwarfism do not choose this option, and it remains controversial.[13] For other types of dwarfism, surgical treatment is not possible.

Society and culture[edit]

Terminology[edit]

The appropriate term for describing a person of particularly short stature (or with the genetic condition achondroplasia) has developed euphemistically.

The noun dwarf stems from Old Englishdweorg, originally referring to a being from Germanic mythology—a dwarf—that dwells in mountains and in the earth, and is associated with wisdom, smithing, mining, and crafting. The etymology of the word dwarf is contested, and scholars have proposed varying theories about the origins of the being, including that dwarfs may have originated as nature spirits or as beings associated with death, or as a mixture of concepts. Competing etymologies include a basis in the Indo-European root *dheur- (meaning 'damage'), the Indo-European root *dhreugh (whence modern German Traum 'dream' and Trug 'deception'), and comparisons have been made with the Old Indiandhvaras (a type of demonic being). The being may not have gained associations with small stature until a later period.[33]

The terms "dwarf", "little person", "LP", and "person of short stature" are now generally considered acceptable by most people affected by these disorders.[17] However, the plural "dwarfs" as opposed to "dwarves" is generally preferred in the medical context, possibly because the plural "dwarves" was popularized by author J. R. R. Tolkien, describing a race of characters in his The Lord of the Rings books resembling Norsedwarfs.[34]

"Midget", whose etymology indicates a "tiny biting insect",[35] came into prominence in the mid-19th century after Harriet Beecher Stowe used it in her novels Sunny Memories of Foreign Lands and Oldtown Folks where she described children and an extremely short man, respectively.[17] Later some people of short stature considered the word to be offensive because it was the descriptive term applied to P. T. Barnum's dwarfs used for public amusement during the freak show era.[13][36] It is also not considered accurate as it is not a medical term or diagnosis, though it is sometimes used as a slang term to describe those who are particularly short, whether or not they have dwarfism.[37]

Dwarf sports[edit]

Dwarfs are supported to compete in sport by a number of organisations nationally and internationally.

Dwarfs are included in some event in the Athletics at the Summer Paralympics

The Dwarf Athletic Association of America and the Dwarf Sports Association UK provide opportunities for dwarfs to compete nationally and internationally in the Americas and Europe, respectively.

The Dwarf Sports Association UK organises between 5 and 20 events per month for athletes with restricted growth conditions in the UK.[38]

For instance, swimming and bicycling are often recommended for people with skeletal dysplasias, since those activities put minimal pressure on the spine.[39]

Since its early days, professional wrestling has had the involvement of dwarf athletes. "Midget wrestling" had its heyday in the 1950s–'70s, when wrestlers such as Little Beaver, Lord Littlebrook, and Fuzzy Cupid toured North America, and Sky Low Low was the first holder of the National Wrestling Alliance's World Midget Championship. In the following couple of decades, more wrestlers became prominent in North America, including foreign wrestlers like Japan's Little Tokyo. Although the term is seen by some as pejorative, many past and current midget wrestlers, including Hornswoggle, have said they take pride in the term due to its history in the industry and its marketability.[citation needed]

Art and media depictions[edit]

See also: Cultural depictions of dwarfism, List of people with dwarfism, and Dwarfs and pygmies in Ancient Egypt

In art, literature, and movies, dwarfs are rarely depicted as ordinary people who are very short but rather as a species apart. Novelists, artists, and moviemakers may attach special moral or aesthetic significance to their "apartness" or misshapenness.

Artistic representations of dwarfism can be found on Greek vases and other ancient artifacts, including ancient Egyptian art in which dwarfs are likely to have been seen as a divine manifestation, with records indicating they could reach high positions in society.[40][41]

The Bhagavat PuranaHindu text devotes nine chapters to the adventures of Vamana, a dwarf avatar of Lord Vishnu.

Depictions of dwarfism are also found in European paintings and many illustrations. Many European paintings (especially Spanish) of the 16th–19th centuries depict dwarfs by themselves or with others. In the Talmud, it is said that the second born son of the EgyptianPharaoh of the Bible was a dwarf.[42] Recent scholarship has suggested that ancient Egyptians held dwarfs in high esteem.[43] Several important mythological figures of the North American Wyandot nation are portrayed as dwarfs.[44]

As popular media have become more widespread, the number of works depicting dwarfs have increased dramatically. Dwarfism is depicted in many books, films, and TV series such as Willow, The Wild Wild West, The Man with the Golden Gun (and later parodied inAustin Powers), Gulliver's Travels by Jonathan Swift,[45]The Wizard of Oz, Willy Wonka & the Chocolate Factory, Bad Santa, A Son of the Circus, Little People, Big World, The Little Couple, A Song of Ice and Fire (and its TV adaptation Game of Thrones), Seinfeld, The Orator, In Bruges, The Tin Drum by Günter Grass, the short-lived reality show The Littlest Groom, and the films The Station Agent and Zero.

The Animal Planet TV series Pit Boss features dwarf actor Shorty Rossi and his talent agency, "Shortywood Productions", which Rossi uses to provide funding for his pit bull rescue operation, "Shorty's Rescue". Rossi's three full-time employees, featured in the series, are all little people and aspiring actors.

In September 2014, Creative Business House, along with Donnons Leur Une Chance, created the International Dwarf Fashion Show to raise awareness and boost self-confidence of people living with dwarfism.[46]

A number of reality television series on Lifetime, beginning with Little Women: LA in 2014, focused on showing the lives of women living with dwarfism in various cities around the United States.

See also[edit]

References[edit]

  1. ^"Definition of DWARFISM". Merriam-webster.com. Retrieved 2017-05-04.
  2. ^"MedlinePlus: Dwarfism". MedlinePlus. National Institute of Health. 2008-08-04. Retrieved 2008-10-03.
  3. ^"FAQ". Lpaonline.org. Retrieved 2017-05-04.
  4. ^ abc"Dwarfism: Symptoms". MayoClinic.com. Mayo Foundation for Medical Education and Research. Retrieved 2009-01-29.
  5. ^"Restricted growth (dwarfism) – NHS Choices". Nhs.uk. Retrieved 2017-05-04.
  6. ^Pauli, RM; Adam, MP; Ardinger, HH; Pagon, RA; Wallace, SE; Bean, LJH; Mefford, HC; Stephens, K; Amemiya, A; Ledbetter, N (2012). "Achondroplasia". GeneReviews. PMID 20301331.
  7. ^ abÇevik, Banu; Çolakoğlu, Serhan (2010). "Anesthetic management of achondroplastic dwarf undergoing cesarean section"(PDF). M.E.J. Anesth. 20 (6). Archived from the original(PDF) on July 13, 2018.
  8. ^ abc"Dwarfism". KidsHealth. Retrieved 2015-06-30.
  9. ^ abHagenäs L, Hertel T (2003). "Skeletal dysplasia, growth hormone treatment and body proportion: comparison with other syndromic and non-syndromic short children". Horm. Res. 60 Suppl 3 (3): 65–70. doi:10.1159/000074504. PMID 14671400. S2CID 29174195. Retrieved 2008-11-17.
  10. ^ abc"Dwarfism: Treatment and drugs". MayoClinic.com. Mayo Foundation for Medical Education and Research. 2007-09-27. Retrieved 2008-11-18.
  11. ^University of Pennsylvania, Arts and Sciences: "The Effect of Adolescent Experience on Labor Market Outcomes: The Case of Height"Archived 2007-07-10 at the Wayback Machine.
  12. ^"Science Blog – Short children more likely to be bullied at school". 3.scienceblog.com.
  13. ^ abcde"Dwarfism Resources: Frequently Asked Questions". Little People of America. 2006-07-09. Archived from the original on 2006-05-16. Retrieved 2006-11-14.
  14. ^"LittlePeople UK". Retrieved 3 October 2013.
  15. ^"Definition of MIDGET". Merriam-webster.com.
  16. ^CDC standard growth charts
  17. ^ abcdKennedy, Dan. "P.O.V. – Big Enough. What is Dwarfism?". Public Broadcasting Service. Retrieved 2008-11-18.
  18. ^"Dwarfism and Bone Dysplasias". Seattle Children's Hospital, Research & Foundation. Archived from the original on 2007-05-04. Retrieved 2008-11-18.
  19. ^ ab"Dwarfism: Complications". MayoClinic.com. Mayo Foundation for Medical Education and Research. Retrieved 2008-11-18.
  20. ^Escamilla RF, Hutchings JJ, Li CH, Forsham P (August 1966). "Achondroplastic dwarfism. Effects of treatment with human growth hormone". Calif Med. 105 (2): 104–10. PMC 1516352. PMID 5946547.
  21. ^"The Pituitary Gland & Growth Disorders: An Overview". Archived from the original on 2013-02-10. Retrieved 2009-02-22.
  22. ^Hall, Judith A.; Adelson, Betty M. (2005). Dwarfism: medical and psychosocial aspects of profound short stature. Baltimore: Johns Hopkins University Press. ISBN .
  23. ^ abGollust SE, Thompson RE, Gooding HC, Biesecker BB (August 2003). "Living with achondroplasia in an average-sized world: an assessment of quality of life". American Journal of Medical Genetics Part A. 120A (4): 447–58. doi:10.1002/ajmg.a.20127. PMID 12884421. S2CID 38614817.
  24. ^Ancient Egypt: Kingdom of the Pharaohs, R. Hamilton, p. 47, Paragon, 2006, ISBN 1-4054-8288-5
  25. ^FGFR3
  26. ^"Achondroplasia – Genetics Home Reference". Genetics Home Reference. National Institute of Health. 2008-09-26. Retrieved 2008-10-01.
  27. ^"Growth Hormone Deficiency". UK Child Growth Foundation. Archived from the original on 2009-01-16. Retrieved 2009-01-16.
  28. ^"Causes of Dwarfism". WrongDiagnosis.com. Retrieved 2009-03-23.
  29. ^A Loss-of-Function Mutation in Natriuretic Peptide Receptor 2 (Npr2) Gene Is Responsible for Disproportionate Dwarfism in cn/cn Mouse* (https://www.jbc.org/article/S0021-9258(19)60512-0/pdf)
  30. ^ ab"DWARFISM (Algorithmic Diagnosis of Symptoms and Signs) - WrongDiagnosis.com". Retrieved 2009-02-22.
  31. ^"Dwarfism: Tests and diagnosis". Mayo Clinic. Mayo Foundation for Medical Education and Research. 2007-08-27. Retrieved 2008-11-18.
  32. ^Jørgensen, Jens O.L.; Christiansen, Jens S. (2005), "Clinical Aspects of Growth Hormone Deficiency in Adults", Growth Hormone Deficiency in Adults, KARGER, 33, pp. 1–20, doi:10.1159/000088338, ISBN , PMID 16166752
  33. ^Simek, Rudolf (2007) translated by Angela Hall. Dictionary of Northern Mythology, pp. 67–68. D.S. BrewerISBN 0-85991-513-1
  34. ^Tolkien, John Ronald Reuel (1955). The Return of the King. George Allen & Unwin. pp. Appendix F.
  35. ^"midget". Online Etymology Dictionary. Dictionary.com. Retrieved 2008-11-18.
  36. ^Adelson, Betty M. (2005). The Lives Of Dwarfs: Their Journey From Public Curiosity Toward Social Liberation. Rutgers University Press. p. 295. ISBN . Retrieved 8 December 2012.
  37. ^"Midget definition". MedicineNet. MedicineNet, Inc. 9 March 2003. Retrieved 2008-11-18.
  38. ^"DSAuk Events". Dsauk.org. Retrieved 2016-02-27.
  39. ^Philadelphia, The Children's Hospital of (25 March 2014). "Skeletal Dysplasias". Chop.edu.
  40. ^Ancient Egyptian Medicine, John F. Nunn, University of Oklahoma Press, 2002, pp. 78–79, ISBN 0-8061-3504-2
  41. ^"Dwarfs Commanded Respect In Ancient Egypt". Sciencedaily.com.
  42. ^The Talmud – Chapter VI. Death Of Jacob And His Sons – Moses – The Deliverance From Egypt. URL accessed April 23, 2007.
  43. ^Kozma, Chahira (2005-12-27). "Dwarfs in ancient Egypt". American Journal of Medical Genetics. 140A (4): 303–11. doi:10.1002/ajmg.a.31068. PMID 16380966. S2CID 797288. Archived from the original on 2013-01-05. Retrieved 2008-11-12.
  44. ^Trigger, Bruce G., The Children of Aataentsic: A History of the Huron People to 1660 McGill-Queen's University Press, 1987 ISBN 0-7735-0627-6, p. 529.
  45. ^Gulliver's Travels: Complete, Authoritative Text with Biographical and Historical Contexts, Palgrave Macmillan 1995 (p. 21). The quote has been misattributed to Alexander Pope, who wrote to Swift in praise of the book just a day earlier.
  46. ^Stark, Stephanie. "The Dwarf Fashion Show Debuts in New York City". Glammonitor. Retrieved 22 July 2015.

External links[edit]

Wikimedia Commons has media related to Dwarfism.
Look up dwarf in Wiktionary, the free dictionary.
Sours: https://en.wikipedia.org/wiki/Dwarfism
I'M A TALL PERSON FOR THE DAY!

Dwarf vs. Midget

Differences in origin of word

Midget, comes from the word midge "small fly" + -et, so that a midget is etymologically a "very small fly". The first reference to the word is found in 1848 in Canada with the meaning "sand fly". In Old English it was "mycg", and it goes back to an Indo-European root, *mu-, which also gave the word mosquito and, by a circuitous route, musket.

The word Dwarf is of Germanic ancestry, coming ultimately from the proto-Germanic root *dhwergwhos meaning "tiny". In Old English it was "dweorg" and meant "person of abnormally small stature".

Physical Condition comparison

When the words were coined, "midget" referred to a person who is small in height but doesn't have disproportionate limbs or other body parts. On the other hand, "dwarf" referred to a person who is small and has disproportionate body parts. A midget was small but proportionate while a dwarf's growth was a disability.

However, since the word "midget" is now considered derogatory and offensive, "dwarf" or "little person" describes any adult human less than 147 cms tall.

Whom does it affect?

Dwarfism is known to affect humans, animals and plants. Midget is a term used for humans only. In humans, a child for whom one or both parents is affected by dwarfism has a chance of inheriting the condition. Both these conditions affect men and women. It is also caused by hormonal or nutritional deficiency.

Differences in associated problems

While there are many problems associated with Dwarfism, midgets are not plagued by these problems. Midgets are just normal people whose height is stunted. In the case of dwarfs, the physical conditions affecting them are: malformed bones, nerve compression, joint disease, and disoriented growth of some organs.

Both midgets and dwarfs have to suffer the psychological or social problems associated with their condition. Social prejudice against their extreme height may reduce their social confidence and opportunites. Sometimes they're mocked and may suffer from low self esteem. Sometimes extreme shortness (height of less than 3 feet) may interfere with their day to day chores.

Differences in treatment

Since the conditions are related to genetic problems, there are few treatments available. Dress enhancements such as shoe lifts etc are some of the few ways to change the aesthetics of little people. Growth hormones are rarely used to treat these conditions as the benefits are very small. The most effective means of increasing adult height by several inches is limb-lengthening surgery, though availability is limited and cost is high in terms of dollars, discomfort, and interruption of life.

References

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The Most Common Types of Dwarfism

Dwarfism occurs when a person has a short stature. It usually results in an adult height of four-feet, 10-inches or shorter. For children, this means being below the height growth curve for their age. This would be less than the third percentile.

The terms usually preferred by people with this condition are "short-statured" or "little person" rather than "​dwarf." The term "midget" is considered to be offensive by many people.

This article will discuss the various kinds of dwarfism. It will also talk about what causes dwarfism and how a doctor diagnoses it.

Types

More than 300 different conditions can cause dwarfism. All people with dwarfism have a short stature. But different things can cause dwarfism. And people with various types of dwarfism have different physical characteristics. Most of the conditions are genetic or inherited at birth. They are also noticeable once the baby is born. There are two main categories of dwarfism:

  • Disproportionate Dwarfism: This means that a person has some average-size parts of the body, such as the head and/or trunk. But they also have some shorter-than-normal parts of the body, such as the legs and arms. The most common type of disproportionate dwarfism—and the most common type of dwarfism in general—is achondroplasia. This is when a person has a normal-size torso but short arms and legs.
  • Proportionate Dwarfism: This means that the person is smaller-than-average all over. Growth-hormone deficiency dwarfism, primordial dwarfism, and Seckel syndrome are all types of proportionate dwarfism.

Dwarfism is a relatively rare condition. Each of the individual types of dwarfism is even rarer.

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Achondroplasia

Achondroplasia makes up 70 percent of all cases of dwarfism. It affects about one of every 25,000 to 30,000 newborns. With achondroplasia, there is a problem with the gene that allows the body to change cartilage to bone while growing. This often occurs in the long bones. People with this type of dwarfism have:

  • A relatively long trunk
  • Short arms and legs
  • Short hands and fingers, with the ring and middle fingers spreading away from eachother
  • A disproportionately large head with a prominent forehead
  • A large, prominent forehead
  • Bowed legs
  • A curved spine

Many people who have achondroplasia have hydrocephalus, which is fluid in the brain. Typically, hydrocephalus associated with achondroplasia is mild. But if it is severe or persistent, the doctor can place a shunt. Some people with achondroplasia also have apnea or sleep apnea. This is a medical condition where you stop breathing or your breathing slows down, especially while sleeping.

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Other

Examples of other types of dwarfism include:

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Causes

Dwarfism can be caused by a genetic condition. It can also be caused by a medical or hormonal condition.

  • Mutations: The majority of people with dwarfism have gene mutations. This means they have changes in specific genes. These mutations interfere with normal development. They may also affect the growth of the cartilage and bones in the body. Since arms and legs have the longest bones, any interference in normal bone development usually results in shorter limbs. This leads to short stature.
  • Genetics: Any genetic change that causes dwarfism can be inherited from parents. It may also develop during fetal development. Two short-statured people can have a non-dwarf child. Average-sized parents can give birth to a child with achondroplasia.
  • Medical Causes: Some non-genetic types of dwarfism can be caused by a growth hormone deficiency. They can also occur if a baby or child's body does not get the nutrients that they need for growth and proper development. A specialist can usually treat these kinds of dwarfism using growth hormones.

How Seckel Syndrome Differs From Other Forms of Dwarfism

Diagnosis

Doctors can diagnose some types of dwarfism during early pregnancy if they use genetic testing.

Some cases of achondroplasia can be diagnosed in the late stages of pregnancy through the use of ultrasound.

Ultrasounds can show shorter-than-average arms and legs, as well as whether the growing baby's head is larger than average. Often, however, dwarfism can't be diagnosed until after the baby is born.

Treatment

Dwarfism itself is not a disease, so there is no "cure." Most people with dwarfism have the same level of intelligence as a person with average height. They also lead healthy, active lives. But the conditions that cause dwarfism can cause health complications. These health complications often involve the spine and lower limbs.

Some medical issues relating to dwarfism are treated with surgery. These surgeries are usually performed on the following parts of the body:

  • back
  • neck
  • leg
  • foot
  • middle ear

Surgical treatments can help improve a little person's quality of life and survival.

If a child is very short, he or she might not receive a diagnosis of dwarfism when there are no other features besides short stature. Many people who are on the short side of the normal growth spectrum do not have dwarfism.

Summary

Dwarfism occurs when a person has short stature. Different things cause dwarfism. Most forms of dwarfism are genetic or inherited at birth. More than 300 genetic conditions can cause dwarfism. It can also be caused by a medical or hormonal condition.

Dwarfism is not a disease, so there is no "cure." Most people with dwarfism have the same level of intelligence as people of average height. They can also lead healthy, active lives just like any other person.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Barstow C, Rerucha C. Evaluation of short and tall stature in children. Am Fam Physician. 2015;92(1):43-50.

  2. Genetic Rare Diseases Information Center. Dwarfism. Updated May 19, 2011.

  3. Pauli RM. Achondroplasia: a comprehensive clinical review. Orphanet J Rare Dis. 2019;14(1):1. doi:10.1186/s13023-018-0972-6

  4. Sleep Apnea. What happens during Osa. May 4, 2011.

Additional Reading
  • Lin S, Li C, Li C, Zhang X. Growth hormone receptor mutations related to individual dwarfism. Int J Mol Sci. 2018;19(5). doi:10.3390/ijms19051433

  • MedlinePlus. Achondroplasia. Published August 18, 2020.

  • Merker A, Neumeyer L, Hertel NT, Grigelioniene G, Mohnike K, Hagenäs L. Development of body proportions in achondroplasia: Sitting height, leg length, arm span, and foot length. Am J Med Genet A. 2018;176(9):1819-1829. doi:10.1002/ajmg.a.40356

Sours: https://www.verywellhealth.com/how-many-types-of-dwarfism-are-there-2860725
Achondroplasia, Causes, Signs and Symptoms, Diagnosis and Treatment.

Dwarfism

What Is Dwarfism?

Here are some facts that people may not realize about dwarfism.

Dwarfism:

  • is characterized by short stature. According to Little People of America (LPA), an advocacy group for people with dwarfism and their families, this means a final height of 4 feet 10 inches or less.
  • can and most often does happen in families where both parents are of average height
  • is often caused by one of over 400 skeletal dysplasias (diss-PLAY-zhee-uhs). These affect bone and growth, and often lead to disproportional short stature.

The most common type of dwarfism is achondroplasia (pronounced: ay-kon-dreh-PLAY-zyuh).

Dwarfism is not:

  • an intellectual disability. Most people with dwarfism have typical intelligence.
  • a disease that requires a "cure." Most individuals with dwarfism live long, fulfilling lives.
  • a reason to assume someone is incapable. Individuals with dwarfism go to school, work, drive cars, marry and raise children, just like their average-height peers.

What Causes Dwarfism?

Most types of dwarfism are caused by a genetic change (mutation) in an egg or sperm cell that happens before the start of pregnancy (conception). Others happen because of a genetic change(s) inherited from one or both parents. Genetic changes happen randomly. There is nothing a parent could do before or during pregnancy to prevent this change from happening. A genetic counselor can help determine the chances of having a child with dwarfism.

Depending on the type of dwarfism, two average-height parents can have a child with short stature. It's also possible for two parents with dwarfism to have an average-height child.

What Are the Types of Dwarfism?

Individuals with dwarfism all have short stature. But there are many different causes of dwarfism. Each has their own unique features and physical traits.

In general, dwarfism caused by a skeletal dysplasia results in disproportionate short stature. This means that the limbs (arms and legs) and the trunk are not of the same proportion as average-height individuals.

The two types of this disproportion are short-trunk and short-limb:

  • Short-trunk dwarfism: The torso is shortened when compared with the limbs.
  • Short-limb dwarfism: The limbs are shortened when compared with the trunk.

By far the most common skeletal dysplasia is achondroplasia. This short-limb dwarfism happens in about 1 of every 25,000 babies born of all races and ethnic groups. People with achondroplasia have a relatively long trunk and shortened arms and legs. This is most noticeable in the upper parts of their arms and legs (called rhizomelic shortening).

Other common features may include:

  • a larger head with a prominent forehead
  • a flattened bridge of the nose
  • shortened hands and fingers
  • a sway of the lower back
  • bowed legs

The average adult height for someone with achondroplasia is around 4 feet tall.

Diastrophic dysplasia is another short-limb dwarfism. It happens in about 1 in 100,000 births. People who have this type tend to have shortened forearms and calves (called mesomelic shortening). They might also have:

  • a cleft palate
  • changes in the outer ear (also known as a cauliflower-like appearance)
  • differently positioned thumbs (also called hitchhiker thumbs)
  • clubfeet (inward or downward pointing feet)
  • spine curves that can change over time

Most people with diastrophic dysplasia have joint changes that limit movement. People with diastrophic dysplasia often benefit from mobility aids, such as crutches, a scooter, or a wheelchair to get around.

Spondyloepiphyseal dysplasias (SED) are short-trunk skeletal dysplasias that involve the spine and the end of the bones that make up the joints (epiphyses). Along with achondroplasia and diastrophic dysplasia, they're one of the more common types of dwarfism. In one type of SED, the short trunk may not be noticed until the child is school age. Other types are seen at birth.

Someone with an SED also might:

  • be born with clubfeet and/or cleft palate
  • have vision and/or hearing differences
  • have instability of the spine and/or curves in the spine that change over time
  • develop reduced joint mobility and arthritis early in life

How Is Dwarfism Diagnosed?

Most pregnant women have a prenatal ultrasound to measure the baby's growth at around 20 weeks. At that stage, features of achondroplasia aren't yet noticeable. Doctors sometimes suspect achondroplasia before birth if an ultrasound late in a pregnancy shows that a baby's arms and legs are shorter than average and the head is larger. But many children with achondroplasia aren't diagnosed until after birth.

Doctors can recognize some other types of skeletal dysplasia earlier in pregnancy. Others aren't noticed until the first few months or years of life, when a child's growth slows. A health care provider may take X-rays after birth to check for bone changes. Doctors also may use genetic testing before or after birth to confirm the diagnosis.

Possible Complications and Treatments

Each condition that causes dwarfism has its own possible medical complications, which can change over time. But doctors can treat many of these.

People with dwarfism are cared for by doctors who specialize in orthopedics, neurosurgery, ENT, and pulmonology. Some medical concerns are treated with surgery. These are done with anesthesia, which can be more of a risk for little people because of their smaller body size and airways.

People with dwarfism should try to keep a healthy weight. A few extra pounds can put harmful stress on the back and joints. It's important for them to find safe and enjoyable physical activities.

What Else Should I Know?

People with dwarfism can lead healthy, active lives. The Americans with Disabilities Act protects their rights.

Types of skeletal dysplasia and the severity of medical needs vary from person to person. In general, with proper medical care, life span is not affected by dwarfism.

Most of the complications that happen in people with dwarfism are physical, not intellectual. In fact, little people often find clever ways to do things in the average-size world. They also interact with people unfamiliar with dwarfism who make assumptions about it. While that can be tough and awkward at times, it's also a chance to enlighten people who don't know much about dwarfism.

Sours: https://kidshealth.org/en/teens/dwarfism.html

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