1. Bone age: For children with precocious puberty, it is necessary to evaluate the bone age in detail and predict the adult height. In the early stage of precocious puberty, the predicted height is often not low. Similarly, because the predicted height can only be predicted according to the normal growth trajectory, children with precocious puberty cannot grow according to the normal growth law because they start puberty too early and the growth period is too short. Without treatment, they are usually significantly lower than the height predicted earlier. However, detailed assessment of bone age and prediction of adult height are very important for choosing treatment scheme and adjusting the dose of gonadotropin-releasing hormone analogue (GnRHa). Knowing the approximate range of predicted height is conducive to choosing a more reasonable treatment plan.

2. Sex hormone levels:

Generally, six kinds of sex hormones should be checked, including at least FSH, LH and E2. Some children with precocious puberty also need to check AFP and HCG to rule out germinoma. In addition, the level of thyroxine (hypothyroidism can cause precocious puberty) was also detected.

3.b-ultrasound examination:

The size of breasts, uterus, ovaries and follicles (or the size of boys' testicles, which can be examined by doctors) determines the sexual development status; Also check the adrenal function or B-ultrasound (excluding the precocious puberty caused by adrenal cortical hyperplasia or tumor, the adrenal gland can also secrete sex hormones).

4, head nuclear magnetic resonance:

Because the pituitary gland is the endocrine center, especially those who suspect central precocious puberty, it is necessary to check the pituitary magnetic resonance (MRI).

5.GnRH provocation test: For those who are more likely to consider true (central) precocious puberty, especially those who need to consider GnRH therapy, except a few who meet the standard of not needing to do GnRH provocation test, GnRH provocation test (hereinafter referred to as sex hormone provocation test) is needed to determine whether it is true precocious puberty. For those with high probability of pseudoprecocious puberty, or those who do not consider GnRH treatment for the time being, GnRH provocation test can be temporarily omitted. Because, if the stimulus is fake, it doesn't mean that it will be fake after a few months, and it needs to be repeated later. In order to alleviate the child's pain or unnecessary examination, you can not do it for the time being, but you must check it regularly. Pseudoprecocious puberty may become true at any time, and most of them will eventually become true, but it will take a long time, otherwise the child will not be able to develop.

6. Growth hormone stimulation test and IGF: For those who need to consider combined growth hormone therapy or use growth hormone therapy because their bones are too old, and those who are too old to use GnRHa, the predicted height will not be too low, and it is not necessary to use GnRHa alone to improve their lifelong height. Those who consider using growth hormone therapy alone should also be examined. special

Auxin provocation test and IGF, etc.