The CPP Diagnosis Process

Once you have been referred to a pediatric endocrinologist, there are a few steps you can expect before you receive an official diagnosis.


Medical History

Your doctor will capture a robust medical history report for your child, and maybe even your family.


Physical Examination

Your doctor will conduct a full physical examination, including height, weight, blood pressure, temperature and pulse. This will include an examination of your child’s private areas (genitals) to check for common CPP symptoms such as pubic hair. This also includes an assessment of breast development in girls and penis and testicle enlargement in boys. While this may seem uncomfortable, it is important to ensure these areas are included in the physical examination.


Diagnostic Testing

  • Bone age test

    An x-ray of the hand and wrist to determine bone age.


    1. Your doctor will take an x-ray of your child’s hand to determine bone age. He or she will then compare these results to standardized bone age charts to determine if your child’s bones are growing too quickly.
    2. This is especially important because early bone growth may not seem like a bad thing now, but early fusion of growth plates can cause your child’s bones to stop growing at too early an age, preventing your child from reaching his or her intended height.
  • Blood test

    A blood sample to measure the various hormones in your child’s bloodstream.

  • GnRH stimulation test

    A hormone stimulation test to measure your child’s pubertal response.


    1. A gonadotropin-releasing hormone (GnRH to similar molecule) stimulation test is standard procedure when diagnosing CPP and ruling out other causes of precocious puberty. This test checks on function of the pituitary gland, to see if it is working normally or is the cause of the early onset of puberty.
    2. During this test, the gonadotropin-releasing hormone (GnRH to similar molecule) is administered into the body via an IV. After about 40 minutes, the nurse will draw your child’s blood to determine if your child has a pubertal response to the hormone.
  • Pelvic and adrenal ultrasound

    This ultrasound examines the development of adrenal glands and ovaries or testicles.

  • MRI or CT Scan

    The goal of these scans is to identify whether brain abnormalities might be the cause of early puberty.

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