peds text 2004 MD consult . . . . . . . . . . . . . . . ..

Tanner stages

TABLE 14-2 -- Classification of Sex Maturity Stages in Girls

SMR Stage	Pubic Hair	Breasts
1	Preadolescent	Preadolescent
2	Sparse, lightly pigmented, straight, medial border of labia	Breast and papilla elevated as small mound; areolar diameter increased
3	Darker, beginning to curl, increased amount	Breast and areola enlarged, no contour separation
4	Coarse, curly, abundant but amount less than in adult	Areola and papilla form secondary mound
5	Adult feminine triangle, spread to medial surface of thighs	Mature, nipple projects, areola part of general breast contour
SMR = sexual maturity rating.
From Tanner JM: Growth at Adolescence, 2nd ed. Oxford, England, Blackwell Scientific Publications, 1962.

TABLE 14-3 -- Classification of Sex Maturity Stages in Boys

SMR Stage	Pubic Hair	Penis	Testes
1	None	Preadolescent	Preadolescent
2	Scanty, long, slightly pigmented	Slight enlargement	Enlarged scrotum, pink, texture altered
3	Darker, starts to curl, small amount	Longer	Larger
4	Resembles adult type but less in quantity; coarse, curly	Larger; glans and breadth increase in size	Larger, scrotum dark
5	Adult distribution, spread to medial surface of thighs	Adult size	Adult size
SMR = sexual maturity rating.
Adapted from Tanner JM: Growth at Adolescence, 2nd ed. Oxford, England, Blackwell Scientific Publications, 1962.