The presence of growth lines in the distal radius was evaluated prior to treatment in 23 psychosocial dwarfs and 25 patients with idiopathic hypopituitarism. The lines were very common in the psychosocial dwarfs and rare in the pituitary dwarfs (P = .0005). This finding can be explained by the fluctuating adverse environment to which the psychosocial dwarf is exposed and the constant lack of growth in hypopituitary patients. Therefore, in the absence of systemic disease, when growth lines are present in a patient with short stature or failure to thrive, a thorough review of the patient's psychosocial environment should be made.