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. For children with chest wall deformities like pectus carinatum, early diagnosis is important to optimize treatment. Therapy is typically most effective when started early, before the chest wall becomes too rigid.

Treatment

Treatment of pectus carinatum is dependent upon the severity of the defect and your child’s symptoms.

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. Brace therapy is most effective when started early, before the chest wall becomes too rigid (stiff) to respond to therapy. Starting brace therapy early enough also allows for evaluation and later surgery if the brace is not successful.
  • Ravitch procedure — In severe or complex cases of pectus carinatum, a surgical procedure may be recommended. In most cases, surgery is not indicated.

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.

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