Mechanical
Anatomical
- increased retroversion
- increased physeal angulation
Increased weight
- overweight immature males
Tall children at end of growth spurt
Biochemical
Hypothyroidism
Hypogonadism, panhypopituitarism, pituitary tumours
Acromegaly
Hyperparathyroidism
Rickets / renal osteodystrohy
Iatrogenic - GH, chemotherapy, XRT
Genetic
Klinefelter’s, Downs, Marfan's