Question

An 11-year-old girl is brought to the pediatri- cian with complaints of back pain. On physical examination, a right thoracic scoliotic curve is noted. The pediatrician mentions to the parent that the development of adolescent idiopathic scoliosis is due to the girl being at peak height growth velocity. Peak height velocity is associ- ated with a certain Tanner stage; what other physical attributes would one expect to occur in this girl at the same time? 

           ( A) Elevation of the breast papilla only, and no pubic hair

1. (B)  Enlargement of the breast and areola with a single contour, and darker, coarse, curled pubic hair

2. (C)  Mature breast, and adult quantity and pat- tern of pubic hair that extends to the thighs 

3. (D)  Projection of the areola and papilla (with separate contours), and adult-type pubic hair limited to the genital area

   (E)  Small breast buds with elevation of breast papilla, and sparse, straight, downy hair on the labial base 

Answer 1

The correct answer is B. Tanner stage 3 is the stage when most girls experience peak height velocity. Peak height velocity occurs approxi- mately one year after the initiation of breast de- velopment. Also, pubic hair becomes dark and curly during this stage.

Answer A is incorrect. This description corre- sponds to Tanner stage 1.

Answer C is incorrect. This description corre- sponds to Tanner stage 5.

Answer D is incorrect. This description corre- sponds to Tanner stage 4.

Answer E is incorrect. This description corre- sponds to Tanner stage 2.