How do I install the Es Sitting Height Measurement skill?

Run npx skillmds@latest add dromlakhani/es-sitting-height-measurement in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Es Sitting Height Measurement safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: docs only. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Es Sitting Height Measurement?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Es Sitting Height Measurement free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Es Sitting Height Measurement?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Es Sitting Height Measurement by dromlakhani

Name: Es Sitting Height Measurement
Rating: 4.2 (5 reviews)
Author: dromlakhani

Es Sitting Height Measurement

This skill involves measuring standing and sitting height in childhood cancer survivors with spinal radiation exposure to assess for disproportionate short stature due to spinal foreshortening, including calculation of the upper-to-lower segment ratio. It is triggered by questions such as "How do I assess for spinal radiation impact on growth?" or "Should I measure sitting height in this survivor with chest/pelvis radiation?"

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Measure sitting height to evaluate spinal radiation effects

STEP 1 — Gather Information

Collect standing height (barefoot, stadiometer), sitting height (sitting height stadiometer or table), leg length if needed, sex, age, ethnicity, and radiation history (type, dose, age at exposure). If sitting height cannot be measured, obtain arm span as an estimate.

STEP 2 — Rule In / Rule Out

Is there a history of radiation that included the spine (TBI, CSI, chest, abdomen, or pelvis)? If yes, proceed; if no, spinal foreshortening assessment via sitting height is not indicated.

STEP 3 — Classify or Stratify

Calculate lower segment = standing height – sitting height (or leg length). Upper segment = sitting height (or standing height – leg length). Compute upper-to-lower segment ratio and compare to age/sex/ethnicity-specific reference values (or Z‑score). Classify as normal ratio or reduced ratio indicating spinal foreshortening.

STEP 4 — Decide

If ratio is reduced, document spinal foreshortening, refer for endocrine evaluation (including GHD testing), monitor growth every 6–12 months, and consider GH therapy only if GHD is confirmed. If ratio is normal, reassess short stature for other causes (e.g., GHD, nutrition).

Clinical Guardrails / Mimics / Pitfalls

Do not rely on sitting height alone if measurement technique is unreliable; avoid using arm span as a substitute unless necessary and interpret with caution. Do not mistake proportionate short stature (e.g., GHD) for spinal foreshortening. Do not initiate GH without confirmed GHD. Remember that reference upper‑to‑lower ratios vary by ethnicity.

Concrete Clinical Example

A 12‑year‑old survivor of medulloblastoma who received CSI 30 Gy at age 5 presents with standing height 130 cm (−2.5 SD) and sitting height 60 cm. Leg length is 70 cm (standing – sitting). Upper‑to‑lower ratio = 60/70 = 0.86, below the expected ~0.90 for age, indicating spinal foreshortening. Endocrine work‑up reveals GHD; GH therapy is initiated after confirmation.

Source: Hypothalamic Pituitary and Growth Disorders in Survivors of Childhood Cancer: An Endocrine Society Clinical Practice Guideline, Sklar et al., 2018, doi:10.1210/jc.2018-01175

TODO: consider adding scripts/calc.py for the es-sitting-height-measurement calculator

---name: es-sitting-height-measurementdescription: This skill involves measuring standing and sitting height in childhood cancer survivors with spinal radiation exposure to assess for disproportionate short stature due to spinal foreshortening, including calculation of the upper-to-lower segment ratio. It is triggered by questions such as "How do I assess for spinal radiation impact on growth?" or "Should I measure sitting height in this survivor with chest/pelvis radiation?"---# Measure sitting height to evaluate spinal radiation effects## STEP 1 — Gather InformationCollect standing height (barefoot, stadiometer), sitting height (sitting height stadiometer or table), leg length if needed, sex, age, ethnicity, and radiation history (type, dose, age at exposure). If sitting height cannot be measured, obtain arm span as an estimate.## STEP 2 — Rule In / Rule OutIs there a history of radiation that included the spine (TBI, CSI, chest, abdomen, or pelvis)? If yes, proceed; if no, spinal foreshortening assessment via sitting height is not indicated.## STEP 3 — Classify or StratifyCalculate lower segment = standing height – sitting height (or leg length). Upper segment = sitting height (or standing height – leg length). Compute upper-to-lower segment ratio and compare to age/sex/ethnicity-specific reference values (or Z‑score). Classify as normal ratio or reduced ratio indicating spinal foreshortening.## STEP 4 — DecideIf ratio is reduced, document spinal foreshortening, refer for endocrine evaluation (including GHD testing), monitor growth every 6–12 months, and consider GH therapy only if GHD is confirmed. If ratio is normal, reassess short stature for other causes (e.g., GHD, nutrition).## Clinical Guardrails / Mimics / PitfallsDo not rely on sitting height alone if measurement technique is unreliable; avoid using arm span as a substitute unless necessary and interpret with caution. Do not mistake proportionate short stature (e.g., GHD) for spinal foreshortening. Do not initiate GH without confirmed GHD. Remember that reference upper‑to‑lower ratios vary by ethnicity.## Concrete Clinical ExampleA 12‑year‑old survivor of medulloblastoma who received CSI 30 Gy at age 5 presents with standing height 130 cm (−2.5 SD) and sitting height 60 cm. Leg length is 70 cm (standing – sitting). Upper‑to‑lower ratio = 60/70 = 0.86, below the expected ~0.90 for age, indicating spinal foreshortening. Endocrine work‑up reveals GHD; GH therapy is initiated after confirmation.**Source:** Hypothalamic Pituitary and Growth Disorders in Survivors of Childhood Cancer: An Endocrine Society Clinical Practice Guideline, Sklar et al., 2018, doi:10.1210/jc.2018-01175> **TODO:** consider adding scripts/calc.py for the es-sitting-height-measurement calculator

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