Dwarfism (Skeletal Dysplasia) and Other Causes of Short Stature

What is dwarfism?

Dwarfism (a form of skeletal dysplasia) is an umbrella medical term that includes hundreds of conditions that affect the growth of bone and/or cartilage, resulting in short stature. People with this condition are usually less than 4 feet 10 inches (1.47 meters) tall as an adult.

Some people with these conditions prefer identifying themselves as “little people,” but the term “midgets” shouldn’t be used.

Dwarfism has many different forms. These conditions can affect different parts of the musculoskeletal system including the growth of the arms, legs, abdomen and/or head.

What are common types of dwarfism (skeletal dysplasia)?

Hundreds of types of dwarfism (skeletal dysplasia) affect bone growth. Some of the most common types include:

• Achondroplastic dwarfism: The most common form of dwarfism is characterized by short limbs and a prominent forehead.
• Hypochondroplasia dwarfism: A mild type of short-limbed dwarfism with characteristics not noticeable during infancy.
• Pituitary dwarfism: Dwarfism caused by a growth hormone deficiency.
• Primordial dwarfism: A form of dwarfism where a small body size occurs during all stages of life, even before birth.
• Thanatophoric dysplasia: A less common, very severe form of dwarfism that causes very short limbs along with a narrow chest. It usually causes infants to die shortly after birth due to breathing difficulties.

What does short stature mean?

“Short stature” is a term that refers to a person who’s shorter than expected for people the same age. In children, this can mean that their height is below typical growth curves or less than expected based on their parents’ heights.

Several factors determine a person’s standing height (or length in babies), including how tall their parents are, their weight and hormone levels. Many genetic conditions can cause people to have short stature.

Who does dwarfism affect?

Dwarfism (skeletal dysplasia) can affect anyone. Many types of dwarfism are genetic, which means you can inherit the condition from your parents and other forms occur randomly through DNA changes. Most often, but not always, dwarfism affects children of parents with average height.

How common is dwarfism?

Dwarfism (skeletal dysplasia) is a rare condition. The most common type of dwarfism is achondroplasia, which affects 1 in 15,000 to 40,000 people.

How does dwarfism affect my body?

Dwarfism (skeletal dysplasia) affects bone growth in your body. The most common bones that dwarfism affects are the long bones in the arms and legs, but it can affect other bones, including those in your abdomen and head. Symptoms of dwarfism can affect other parts of your body and lead to long-term health problems, like weak muscle tone or frequent infections.

What are the symptoms of dwarfism?

The most common symptom of dwarfism (a form of skeletal dysplasia) is short stature. A person diagnosed with any type of dwarfism will almost always have a height below 4 feet 10 inches, or 1.47 meters, as an adult. Short stature is more noticeable during puberty and adulthood rather than during childhood.

Most causes of being short are proportionate, meaning that everything is small and not just certain parts of your body. Some forms of dwarfism refer to short stature as disproportionate, which means that a person has an average-sized torso and short arms and legs.

Symptoms of dwarfism can include:

• Bowed legs.
• Flat nasal bridge (bony area at the top of the nose).
• Large head.
• Prominent forehead.
• Short arms and legs.
• Short fingers and toes.
• Wide hands and feet.

Symptoms of dwarfism can sometimes lead to additional health concerns due to abnormal bone growth, including:

• A buildup of fluid around the brain (hydrocephalus).
• Compressed nerves.
• Curved spine (scoliosis).
• Ear infections or hearing problems.
• Knee and ankle pain.
• Sleep apnea.

What causes dwarfism?

Several potential causes lead to a dwarfism (skeletal dysplasia) diagnosis. A change to a person’s DNA causes most cases of dwarfism, while several types have an unknown cause.

Causes of dwarfism include:

• Familial: If parents and other family members are short, it can be normal for their child to be short.
• Genetic mutation: Changes to a person’s DNA.
• Growth hormone deficiency: The brain doesn’t make enough of the hormone that causes bones to grow.
• Late bloomer (constitutional delay): Some children are short earlier in childhood because they’re programmed to grow later than their peers. There’s sometimes a family history of a similar pattern of growth.
• Malnutrition: Not having adequate nutrition can affect a child’s ability to grow.
• Small for gestational age: Most babies that are born small will catch up with their growth within the first two to three years of life, but 10% don’t.

Is dwarfism genetic?

Yes, some types of dwarfism (caused by skeletal dysplasia) are genetic and result from a change in a person’s DNA. In most cases, the genetic mutation happens randomly and isn’t passed from a short-statured parent to a child. This means that most parents who have children diagnosed with dwarfism are of average height.

The rate that a child will inherit the condition increases if one or both parents have a dwarfism diagnosis and varies depending on which form of dwarfism a person has. For example, a parent with achondroplasia has a 50% chance of passing the condition on to their child. If both parents have achondroplasia, there’s a 25% chance their child will be born with a dangerous form of dwarfism called homozygous achondroplasia, which leads to stillbirth or death shortly after birth and a 50% chance for typical achondroplasia.

If you plan on becoming pregnant and want to understand your risk of having a child with an inherited condition like achondroplasia or dwarfism, contact your healthcare provider about genetic testing.

How is dwarfism diagnosed?

Your healthcare provider can diagnose dwarfism (skeletal dysplasia) before birth, in some cases. During pregnancy, your provider will use prenatal screening tests to identify any growth abnormalities in your child.

After your child is born, your provider will keep track of your child’s growth during annual wellness visits. If your baby didn’t receive an early diagnosis of dwarfism (skeletal dysplasia) at birth, a diagnosis could come later if your child misses growth milestones, which are a sign of the condition. Additional tests, like an X-ray and blood tests, can help your provider identify why your child isn’t growing at a normal rate, which will lead to their diagnosis.

How is dwarfism treated?

Treatment for dwarfism (skeletal dysplasia) is unique for each person based on their specific diagnosis and addresses symptoms of the condition, since there’s no cure.

Surgical treatment to address symptoms could include surgery to:

• Correct bones growing in an abnormal direction or the shape of bones.
• Remove excess fluid from around the brain (hydrocephalus).
• Reduce brain stem compression, which is pressure on the part of the brain that connects to the spinal cord.
• Improve breathing by removing tonsils and/or adenoids.
• Add tubes in the ears to prevent ear infections.

Other types of treatment to address symptoms of dwarfism (skeletal dysplasia) that don’t involve surgery include:

• Using a CPAP (continuous positive airway pressure) machine for sleep apnea.
• Using hearing aids to improve hearing.
• Encouraging healthy eating habits and exercise to prevent excess weight gain or obesity (a BMI, or body mass index, of 30 or higher).
• Taking growth hormones (hormone therapy) to treat a growth hormone deficiency.
• In 2021, the U.S. Food and Drug Administration approved the use of vosoritide (Voxzogo®) in children with achondroplasia who are 5 years and older but whose bone growth plates are still open (this means they’re not finished growing yet). In a clinical trial, vosoritide helped speed children’s growth.

Treatment for dwarfism is lifelong and helps improve a person’s quality of life.

How can I reduce my risk of having a child with dwarfism?

Since some types of dwarfism (skeletal dysplasia) are genetic, there’s no way to prevent the condition unless a healthcare provider uses a screening test like pre-implantation genetic testing. To better understand your risk of having a child with a genetic condition like dwarfism, contact your healthcare provider about genetic testing.

Nutrition plays a vital role in your child’s growth. If you’re pregnant, make sure you eat a well-balanced diet. When your child is born, they should also eat a variety of healthy, age-appropriate foods — like protein, fruits, grains and vegetables — which will give them all the nutrients they need to grow.

What can I expect if I have a child diagnosed with dwarfism?

Although there’s no cure for dwarfism (skeletal dysplasia), many people of short stature have a normal life span and good health with treatment to address their symptoms. There are potential symptoms of the condition that could take a toll on your child and your family, especially if their abnormal bone growth requires multiple surgeries. Your healthcare provider will work closely with you and your child to make sure they receive the treatment they need to live a full and healthy life.

What is the life expectancy for someone with dwarfism?

For many forms of dwarfism, people diagnosed have a normal life expectancy with treatment to manage their symptoms. Other forms, unfortunately, have a shorter lifespan.

How do I take care of my child with dwarfism (skeletal dysplasia)?

Once your child’s medical needs are met, you can support them by creating an environment that welcomes them and makes them feel included by:

• Removing physical challenges in your home to promote independence (using a step stool, lowering light switches).
• Providing educational and/or emotional support to prevent or address bullying in school.
• Engaging with organizations that support children with similar diagnoses.

Parents should balance the need to treat their children in a way that’s appropriate for their age, not their height.

What questions should I ask my doctor?

• Does my child need surgery to treat their symptoms?
• How can I help my child prevent ear infections?
• Are there side effects to the treatment you recommend?
• How often does my child need to take growth hormones?

A note from Cleveland Clinic

Although your child diagnosed with dwarfism (skeletal dysplasia) might need surgery or long-term treatment to manage their symptoms, it doesn’t necessarily mean they can’t live a full and meaningful life. As their caregiver, remember to treat your child according to their age, not their height. This will improve your child’s self-esteem and help them feel included and loved.

If you’re an adult with dwarfism, having a good support system, managing your symptoms and leading a healthy lifestyle can help you live a full and active life.