Pectus carinatum (pigeon chest)

What is pectus carinatum (pigeon chest)?

Pectus carinatum is an abnormal growth of rib cartilage that pushes the sternum out, away from the spine. Also known as “pigeon chest”, pectus carinatum is identified by examination of the sternum (breastbone) which has a characteristic protrusion, causing the chest to grow outward.

The condition rarely affects the function of the heart and lungs but is often associated with chest pressure and pain.

What are the signs and symptoms of pectus carinatum (pigeon chest)?

Pectus carinatum is usually noticed during a growth spurt between 12 and 14 years of age. It may not have any physical symptoms. Some patients complain of pain over the area where the cartilage is pushing on the breastbone. Symptoms improve with treatment.

Some patients are very self-conscious because of the appearance of the pectus carinatum deformity. Correction of the deformity may play a significant role in improving the self-esteem of some patients.

This condition is more common in boys, and tends to worsen in severity with age and during growth spurts that occur in late childhood and adolescence.

How is pectus carinatum (pigeon chest) diagnosed?

To diagnose pectus carinatum, your child’s provider will do a detailed physical examination.

What are the causes of pectus carinatum (pigeon chest)?

While the cause of this abnormality is unknown, the fact that it may occur in families suggests that genetics may play a role. Pectus carinatum may be associated with some inherited connective tissue disorders such as Marfan syndrome, homocystinuria and Ehlers-Danlos syndrome.

We are one of only a few centers in the United States with a clinic offering the Dynamic Compression Bracing System.

How is pectus carinatum (pigeon chest) treated?

Bracing

Most children can be treated for pectus carinatum with bracing. The brace gently helps push the breastbone and remold the chest by applying measured, gentle pressure. In a small percentage of children and when bracing is unsuccessful, an operation to correct the position of the breastbone is recommended.

• Trulife® circular brace is an off-the-shelf brace that is not customized. The affected area must be centrally located for this brace to have optimum results.

• Dynamic compression brace is designed with front compression plates anchored to bars that encircle the chest, and is custom-fabricated based upon measurements of your child’s chest. It may be worn over a thin shirt, and hidden under regular clothing.

Our center, at Children's Health, is one of the few in the United States with a dedicated team that has been trained to complete the customized measurements of the chest, supply the brace and provide follow up.

Your child must wear the brace for at least 10 hours a day and treatment can last between six to 20 months. During regular check-ups at our Pectus Clinic, the brace will be adjusted for comfort and compression. Initially, your child will wear the brace for a few hours a day, with that time gradually increasing to a minimum of 10 to 12 hours a day. As the chest begins to reach the desired shape, the wear time will then gradually decrease to retainer mode.

It is important to understand that best results come when a child wears the brace consistently and according to directions.

Surgery

• The Ravitch procedure is for older children and adolescents and is performed when bracing has not been successful or not possible due to chest wall deformity. The procedure requires an incision across the chest. The surgeon will remove the abnormal rib cartilage between the boney ribs and the breast bone which allow the breast bone to be placed into its normal position. An absorbable strut will be placed in your child's chest to keep the breast bone in place until the cartilage can regrow.