Abnormally long and slender fingers ("spider fingers").

The middle finger is more than 2 SD above the mean for newborns 27 to 41 weeks EGA or above the 97th centile for children from birth to 16 years of age AND the five digits retain their normal length proportions relative to each other (i.e., it is not the case that the middle finger is the only lengthened digit), or, Fingers that appear disproportionately long compared to the palm of the hand.

Toes that appear disproportionately long compared to the foot.

Reduced width of the cross sectional diameter of the fibula.

A height below that which is expected according to age and gender norms. Although there is no universally accepted definition of short stature, many refer to "short stature" as height more than 2 standard deviations below the mean for age and gender (or below the 3rd percentile for age and gender dependent norms).

Slow or limited growth after birth.

Impairment of certain skills such as reading or writing, coordination, self-control, or attention that interfere with the ability to learn. The impairment is not related to a global deficiency of intelligence.

Osteopenia is a term to define bone density that is not normal but also not as low as osteoporosis. By definition from the World Health Organization osteopenia is defined by bone densitometry as a T score -1 to -2.5.

A reduction of bone mineral density, that is, of the amount of matter per cubic centimeter of bones.

Head circumference below 2 standard deviations below the mean for age and gender.

An abnormally elevated concentration of insulin like growth factor binding protein acid labile subunit level in the blood circulation.

Delayed tooth eruption, which can be defined as tooth eruption more than 2 SD beyond the mean eruption age.

Facial contour, as viewed from the front, triangular in shape, with breadth at the temples and tapering to a narrow chin.

Decreased vertical distance from the vermilion border of the lower lip to the inferior-most point of the chin.

An increased concentration of insulin in the blood in the fasting state, i.e., not as the response to food intake.