Dwarfism

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Template:DiseaseDisorder infobox, Template:ICD9 | }} Dwarfism is a condition in which a person, animal or plant is much below the ordinary size of the species. When applied to people, it implies not just extreme shortness, but a degree of disproportion. Dwarfism is now rarely used as a medical term and is sometimes (but not always) considered impolite or pejorative. Today, the term little person tends to be preferred. According to the Little People of America the human definition of dwarfism is "a medical or genetic condition that usually results in an adult height of 4'10" (147 cm) or shorter, among both men and women, although in some cases a person with a dwarfing condition may be slightly taller than that."

Of the hundreds of causes of dwarfism in humans, most are genetic, and most involve single gene variations that affect the structure or metabolism of bone, cartilage, or connective tissue. This class of disorder is referred to by physicians as skeletal dysplasia. Chondrodystrophy, chondrodysplasia, osteochondrodystrophy are also used (fairly interchangeably) in the medical literature to refer to most of these conditions. In many of these conditions, the bones are the primary affected body part, and the person is otherwise healthy. In many others, the genetic difference affects other body systems, causing unusual features or other major problems. Achondroplasia is one of the most common and perhaps the most easily recognized skeletal dysplasia. It affects approximately 1 in 40,000 children, both males and females, as it is due to a mutation of an autosomal gene.

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Problems faced by people with these conditions

  • Social and employment opportunities are greatly reduced, regardless of anti-discrimination laws. Self-esteem and family relationships are often affected, although not necessarily if the person(s) involved are emotionally healthy.
  • Extreme shortness (in the low 2–3 foot [60–90 cm] range) can interfere with ordinary activities of daily living, like driving or even using countertops built for taller people.
  • Many can have problems produced by the abnormal bone structures. Early degenerative joint disease, exaggerated lordosis or scoliosis, and constriction of spinal cord or nerve roots can cause pain and disability. Reduced thoracic size can restrict lung growth and reduce pulmonary function.
  • Many of the conditions are associated with disordered function of other organs, such as brain or liver (although this is rare). These problems can be more disabling than the abnormal bone growth.
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Diagnosis

Shortness is usually the concern that brings the child to medical attention. Skeletal dysplasia ("dwarfism") is usually suspected because of obvious physical features (e.g., unusual configuration of face or shape of skull), because of an obviously affected parent, or because body measurements (arm span, upper to lower segment ratio) indicate disproportion. Bone x-rays are often the key to diagnosis of a specific skeletal dysplasia. Most children with suspected skeletal dysplasias will be referred to a genetics clinic for diagnostic confirmation and genetic counselling. See below external links for a list of American referral centers with special expertise in skeletal dysplasias. In the last decade, genetic tests for some of the specific disorders have become available.

During the initial medical evaluation for shortness, the absence of disproportion and the other clues above usually indicates other causes than bone dysplasias. Extreme proportional shortness sometimes indicates growth hormone deficiency.

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Terminology

Little person (as opposed to big person), and short-statured are currently preferred terms to refer to a person with extreme, disproportionate shortness. Dwarf is sometimes perceived as having negative connotations, although the term is often used by those affected. The plural is dwarfs as in "Peter Dinklage and Wee Man are famous, handsome dwarfs." The plural term dwarves is used only for the imaginary creature. In the 19th century both dwarf and midget were ordinary medical terms referring to persons of disproportionate and proportionate shortness, respectively. Like many other older medical terms, they became primarily pejorative as they entered popular use. Midget is now considered offensive in all contexts to most little people, because of its connotation with little people being gawked at in circus/sideshows.

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In popular culture and the arts

Image:Velazquez-dwarf-don-sebastian-de-morra.jpg

Dwarfism is such an obvious difference that it attracts curiosity, humor, and imagination. People have paid just to look at dwarfs or to keep them around for amusement (for example, dwarf tossing). In many times and places this may be the most attractive employment option available, as was the case for some jesters of medieval Europe.

When depicted in art, literature, or movies, dwarfs are rarely depicted as "regular people who are very short" but often as a species apart. Novelists, artists, and moviemakers attach special moral or aesthetic significance to the "apartness" or the misshapenness.

Artistic representations of dwarfism can be found on Greek vases and other ancient artifacts, including ancient Egyptian art. Many European paintings (especially Spanish) of the 16th–19th centuries depict dwarfs by themselves or with others.

Several novels have treated dwarfism as a major theme, not necessarily realistically:

Leslie Fiedler's Freaks: Myths and Images of the Secret Self (1979) is considered an intelligent and sensitive exploration of the cultural significance and artistic treatments of differentness. Other readers may feel that he valued physically unusual people for their differentness, not for their personhood, when he laments medical treatment for reducing the number of picturesquely different people around.

Several 20th and 21st century movies & TV shows have addressed the topic or made much use of dwarfs:

The actor and stunt man Verne Troyer has become famous playing the character "Mini-Me" in two Austin Powers movies.

The 1960s television series The Wild Wild West featured a dwarf, Michael Dunn, as the recurring character Dr. Miguelito Loveless, the brilliant but insane archenemy of Secret Service agents James West and Artemus Gordon.

In the 1990s, the immensely popular series Seinfeld featured a dwarf character, Mickey Abbott, in seven episodes; Mickey was played by actor Danny Woodburn. Notably, he was a normal character and few references were made to his height, indicating an improved acceptance of little people in entertainment.

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Famous people with dwarfism

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See also

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External links

de:Minderwuchs es:Enanismo eo:Nanismo fr:Nanisme he:גמד (רפואה) pt:Anões fi:Lyhytkasvuisuus

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