Pectus Carinatum

  • What is pectus carinatum

    Pectus carinatum is a condition that causes the chest to a have a “bowed out” or “pigeon chest” appearance. The condition, which affects one out of every 500 children, is caused by an overgrowth of the costal cartilages which connect the ribs to the sternum. Pectus carinatum affects more boys than girls and usually begins during early puberty (10-13 years old).

  • Symptoms

    Although some children have pain and tenderness in the “bowed out” area, most children with pectus carinatum do not have any symptoms. Pectus carinatum does not usually have an effect on the function of the heart or lungs, except in severe cases.

  • Causes

    There is no known cause for pectus carinatum. It can sometimes run in families — which suggests genetics may play a role.

    Pectus carinatum can also be associated with connective tissue disorders such as Marfan syndrome and Ehlos-Danlos syndrome. About 20 percent of children with pectus carinatum also have scoliosis.

  • Diagnosis

    Pectus carinatum is diagnosed by a thorough health history and physical exam.

  • Treatment

    Treatment of pectus carinatum is dependent upon the severity of the defect and your child’s symptoms. In most cases, surgery is not indicated.

    At CHOP, we offer two treatments for pectus carinatum. After a thorough examination, we may recommend:

    • Observation and external brace therapy — External brace therapy and ongoing observation is helpful for children with mild to moderate cases of pectus carinatum.
    • Ravitch procedure — In severe or complex cases of pectus carinatum, a surgical procedure may be recommended. Surgery is performed at age 17 or older.

    The Children’s Hospital of Philadelphia created a printable resource to help you better understand pectus carinatum and the bracing typically used to treat the condition. See Caring for Your Child: The Pectus Carinatum Brace for details.

Reviewed by N. Scott Adzick, MD, MMM, FACS, FAAP, Mary Kate Klarich, MSN, CRNP, Natalie Walker, RN, MSN, CRNP on March 01, 2012