True precocious puberty represents a serious developmental disorder necessitating immediate therapeutic measures, whereas premature thelarche is a harmless variation from the norm. For the differential diagnosis the ultrasonographic evaluation of the internal genitalia is of value. Girls with precocious puberty reveal a statistically significantly greater uterus length and volume as well as ovarian size. The stimulated LH/FSH quotient allows verification of the diagnosis. This value is found always to be greater than 1 in precocious puberty and always less than 1 in premature thelarche.
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