Editing Dwarfism (section)

==Signs and symptoms==
[[File:Dackelpferd.jpg|thumb|upright=1.3|Dwarfism occurs in animals as well as humans; horses can have [[achondroplastic]] symptoms, as shown here next to a person with dwarfism. All small dog breeds exhibit dwarfism (the standard size of dogs, without [[Dog breeding|interference from humans]], is the same as that of the wolves).]]
Dwarfism has been defined as having an adult height of less than {{convert|4|ft|10|in|cm|order=flip}},<ref name=NLM2008/><ref name="lpaonline"/><ref name="mayo-symptoms"/> or alternatively, having a height of at least two [[standard deviation]]s less than the mean of an individual's population, considering age, sex, and ancestry.<ref>{{cite journal |last1=Jain |first1=Megha |last2=Saber |first2=Ahmed Y. |date=2023-06-24 |title=Dwarfism |url=https://www.ncbi.nlm.nih.gov/books/NBK563282/ |journal= StatPearls [Internet] | publisher = StatPearls Publishing |access-date=23 March 2025 }}</ref><ref>{{cite journal |last1=Grunauer |first1=Michelle |last2=Jorge |first2=Alexander A L |date=Feb 2018 |title=Genetic short stature |url=https://pubmed.ncbi.nlm.nih.gov/29249624/ |journal= Growth Horm IGF Res. |volume=38 |issue=Epub 2017 Dec 6|pages=29–33 |doi=10.1016/j.ghir.2017.12.003 |pmid=29249624 |access-date=23 March 2025 }}</ref><ref>{{Cite web|url=https://www.cdc.gov/growthcharts/clinical_charts.htm|title=Growth Charts – Clinical Growth Charts|date=11 January 2019|website=Cdc.gov|access-date=2 March 2022}}</ref> 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. However, those with mild [[Osteochondrodysplasia|skeletal dysplasias]] may not be affected by dwarfism. In some cases of untreated [[hypochondroplasia]], males grow up to {{convert|5|ft|5|in|cm|abbr=in|order=flip}}. 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.<ref name="dwarfism-pbshome" /> 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,<ref name="mayo-symptoms">{{cite web|url=http://www.mayoclinic.com/health/dwarfism/DS01012/DSECTION=symptoms |title=Dwarfism: Symptoms |access-date=2009-01-29 |work=MayoClinic.com |publisher=Mayo Foundation for Medical Education and Research }}</ref> 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.<ref name="LPA" /> Early degenerative joint disease, exaggerated [[lordosis]] or [[scoliosis]], and constriction of [[spinal cord]] or nerve roots can cause pain and disability.<ref name="seattle-dysplasia">{{cite web |url=http://orthopedics.seattlechildrens.org/conditions_treated/dwarfism_and_bone_dysplasias.asp |title=Dwarfism and Bone Dysplasias |access-date=2008-11-18 |publisher=Seattle Children's Hospital, Research & Foundation |url-status=dead |archive-url=https://web.archive.org/web/20070504091309/http://orthopedics.seattlechildrens.org/conditions_treated/dwarfism_and_bone_dysplasias.asp |archive-date=2007-05-04 }}</ref> Reduced [[thorax|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.<ref name="mayo-complications">{{cite web|url=http://www.mayoclinic.com/health/dwarfism/DS01012/DSECTION=complications |title=Dwarfism: Complications |access-date=2008-11-18 |work=MayoClinic.com |publisher=Mayo Foundation for Medical Education and Research }}</ref><ref name="pmid5946547">{{cite journal |vauthors=Escamilla RF, Hutchings JJ, Li CH, Forsham P |title=Achondroplastic dwarfism. Effects of treatment with human growth hormone |journal=Calif Med |volume=105 |issue=2 |pages=104–10 |date=August 1966 |pmid=5946547 |pmc=1516352 }}</ref> Mental effects also vary according to the specific underlying syndrome. In most cases of skeletal dysplasia, such as achondroplasia, mental function is not impaired.<ref name="mayo-symptoms" /> 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.<ref>{{cite web |url=http://www.hormone.org/Growth/overview.cfm |title=The Pituitary Gland & Growth Disorders: An Overview |access-date=2009-02-22 |archive-url=https://web.archive.org/web/20130210025422/http://www.hormone.org/Growth/overview.cfm |archive-date=2013-02-10 |url-status=dead }}</ref>

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.<ref name="{{ISBN|0-8018-8121-8}}">{{cite book |author1=Hall, Judith A. |author2=Adelson, Betty M. |title=Dwarfism: medical and psychosocial aspects of profound short stature |publisher=Johns Hopkins University Press |location=Baltimore |year=2005 |isbn=0-8018-8121-8 }}</ref><ref name="pmid12884421">{{cite journal |vauthors=Gollust SE, Thompson RE, Gooding HC, Biesecker BB |date=August 2003 |title=Living with achondroplasia in an average-sized world: an assessment of quality of life |url=https://onlinelibrary.wiley.com/doi/10.1002/ajmg.a.20127 |journal=American Journal of Medical Genetics Part A |volume=120A |issue=4 |pages=447–58 |doi=10.1002/ajmg.a.20127 |pmid=12884421 |s2cid=38614817|url-access=subscription }}</ref>
* Numerous studies have demonstrated reduced employment opportunities. Severe shortness is associated with lower income.<ref name="pmid12884421"/>
* [[Self-esteem]] may decline and family relationships may be affected.
* Extreme shortness (in the {{convert|60|-|90|cm|ft|0|abbr=in|disp=or}} 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.<ref name="mayo-complications"/>