Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: (Pediatrics) 24 month old white female with discordant bone age. 31" tall, 21 pounds. No meds, no surgeries.(Pediatrics) 24 month old white female with possible short stature. 31" tall, 21 pounds. No meds, no surgeries.My 2 year old hasn't been getting very tall as she's gotten older. She's dropped to the first percentile for height. Her first pediatrician wasn't overly concerned, but we saw a new pediatrician and she was concerned and had her x-rayed. I got the report back, but the doctor is out of the office so I won't be able to talk to her until next week.The radiology report says:FINDINGS: A single radiograph of the hand was provided for evaluation of bone age. The patient's chronological age is 24 months. The hand bone age according to the tables of Greulich and Pyle is approximately 2 years. The wrist bone age most closely approaches that of 1 year and 3 months. The standard deviation for the patient's chronological age is 4.64 months. No structural abnormalities are identified.IMPRESSION:Discordant bone age between the hand and wrist, but both are within 2 standard deviations of chronological age per the age and gender matched standards of Greulich and Pyle.Is the discrepancy worrisome?https://flic.kr/p/2nS9y6S. ### Response: Worrisome probably isnt the right term. It isnt indicative of anything dangerous.It can sometimes indicate a hormonal issue that requires endocrine referral.But will also say that pediatric endocrinologists and radiologist often disagree on bone ages.Bone ages are pretty subjective. Basically they x-ray the hand in a specific way and then compare it to a book with known bone ages and say eh, I think it looks like this one the most..