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Continuity Clinic Notebook:

Chapter III. Adolescent Issues

Chapter 3 Index

A. General:
--
Approach to the Adolescent Patient
--Managing Problem Health Behaviors in Adolescents
--Health Screening and Prevention Guidelines for Teens

 

Tanner Staging

I. Girls

Tanner Stage Stage of develop Pubic Hair Breasts
Stage 1 Early adolescence
(10-13 years)
Preadolescent Preadolescent
Stage 2   Sparse, straight small mound
Stage 3 Middle adolescence
(12-14 years)
Dark, curl bigger; no contour separation
Stage 4   Coarse, curly, abundant Secondary mound of areola
Stage 5 Late Adolescence
(14-17 years)
Triangle; medial thigh nipple projects; areola part of breast

I. Boys

Tanner Stage Stage of develop. Pubic Hair Penis Testes
Stage 1 Early adolescence
(10.5-14 years)
None Preadolescent preadolescent
Stage 2   Scanty Slight increase larger
Stage 3 Middle adolescence
(12.5-15 years)
Darker, curls Longer larger
Stage 4   adult, coarse, curly Larger scrotum dark
Stage 5 Late adolescence
(14-16 years)
adult - thighs Adult adult

Middle Adolescence (Stages 3 and 4): acceleration of weight and growth as well as above secondary sex characteristics.  Pubic hair first, then axillary, then facial hair.

  • Female: menarche (average age 12 years) - can occur in Stages 1 and 2; usually 3 and 4 factors affecting: nutrition, genetic - age of mother’s menarche.
  • Male: gynecomastia also appears during middle adolescence: up to 70% of normal males.

Should Tanner 1 boys be allowed to play football with Tanner 5s?  Controversial.  Dr Landry of Madison Wisconsin says that there is no problem.  However some literature states that adolescents that have gone through puberty recently are at higher risk of injury. (Clinical Journal of Sport Medicine 1995;5:167-70) Also study of strength, flexibility and maturity correlate better with Tanner staging than with chronological age. (AJDC 1989;143:560-3)

All agree that we worry about these mismatches in sports.

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Department of Pediatrics  |  Medical College of Georgia
Please email comments, suggestions or questions to:
John T.  Benjamin M.D., 
jbenj@mcg.edu

February 27, 2004