Short stature (height < 148 cm) is caused by a heterogeneous mix of conditions with genetic, constitutional, or metabolic origins. It can be classified into conditions causing proportionate or disproportionate short stature depending on the trunk-limb ratio. Disproportionate short stature is largely due to the skeletal dysplasia disorders, of which achondroplasia is the most common condition. Pregnancy and delivery are high risk periods in these patients given the increased risk of cardiorespiratory compromise from the physiological changes in pregnancy in addition to the high risk of cesarean deliveries from cephalopelvic disproportion and decompensated maternal and fetal conditions. Anesthesia management is challenging as anatomic abnormalities result in increased difficulty and increased risk of complications with both neuraxial and general anesthesia. There are also challenges around use of equipment, intraoperative monitoring, dosing of neuraxial anesthesia agents and postoperative management. Despite these difficulties there is a significant number of reports in the literature on the successful management of parturients with short stature. These reports can help guide anesthesiologists in ensuring the safe care of this unique patient population.

This chapter covers clinical examination of the child through growth and development. It includes neonatal presentation to the orthopaedic surgeon, e.g. with dislocating hips or obstetric brachial plexus palsy. All joint examinations in the child are described with the differences in a child compared to an adult emphasised. Included in the chapter are rotational profile assessment, leg length assessment, assessing a child with skeletal dysplasia and how to examine a child with spina bifida.

This chapter looks at a spectrum of paediatric clinical cases ranging from generalised conditions such as Ehlers– Danlos syndrome to tibial bowing and foot disorders. Skeletal dysplasia and rotational and other malalignments are also covered. The emphasis of the cases shown is to demonstrate how clinical features can contribute to management.

Accurate age-at-death estimates are essential for inferring health, identity, diversity, and demography within archaeological skeletal samples. Unfortunately, the macroscopic skeletal structures may be compromised by dysplastic, endocrine, and circulatory disorders. Cementochronology provides a reliable alternative approach for evaluating acellular cementum banding. Using cementochronology, we present an age-at-death estimate for a pre-Columbian, adult female with a combined skeletal dysplasia, achondroplasia and Leri-Weill dyschondrosteosis. Cementochronology has re-defined the age-at-death estimate between 30 to 34 years. These results not only assist in developing a more accurate age-at-death estimation and biological profile, but they also facilitate creating nuanced interpretations for a physically challenged, pregnant female in her Middle Woodland social context. Further, this analysis emphasizes the utility of cementochronology in estimating age-at-death of skeletal individuals with pathological conditions that compromise commonly used macroscopic methods and encourages researchers to consider this technique in paleodemography, paleoepidemiology, and forensic anthropology.