Case 3: Prognathism in a 13-year-old Boy

Jacqueline T. Chan; Carla Z. Minutti

doi:10.1542/pir.2016-0154

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Jacqueline T. Chan, MD*
Carla Z. Minutti, MD^†

^*Children’s Hospital University of Illinois at Chicago, Chicago, IL
^†Rush University Medical Center, Chicago, IL

AUTHOR DISCLOSURE
Drs Chan and Minutti have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Dr Chan's current affiliation is Medical College of Georgia at Augusta University, Augusta, GA.

Presentation

A previously healthy 13-year-old boy presents to the clinic for evaluation of prognathism. The mother reports that his jaw has grown disproportionately in the past 2 years and he is unable to close his mouth. The mother also mentions that he has been growing fast for the past 3 to 4 years and that she has frequently been buying him larger shoes and clothes. He denies headaches or blurry vision. Family history is negative for prognathism or tall stature. On examination he is found to be above the 95th percentile for height (midparental height around the 20th percentile), and his weight is at the 90th percentile. His vital signs are normal. Physical examination is pertinent only for prognathism. He is unable to completely close his mouth. He is Tanner stage 4-5.

Review of previous records shows crossing of height percentiles from the 75th to above the 95th from 9 to 11 years old, whereas his weight has been stable. Records before this age were not available because the patient is …