SHOX and hyperinsulinemic hypoglycemia, familial, 4: They suggested that screening for SHOX mutations should be limited to patients whose ETR is <1.95 + 1⁄2 height (m) and close inspection of a hand radiograph to detect the main characteristics of SHOX deficiency (pyramidalisation of the carpal row, radiolucency of the distal radius at the ulnar border, and triangularisation of the distal radius) in school-age children.