Chest Wall Deformities

Chest Wall Deformities

What are chest wall deformities?

A chest wall deformity is a structural abnormality of the chest that can range from mild to severe. Chest wall deformities occur when the cartilage that connects the ribs grows unevenly. It is not clear why this happens, but the condition tends to run in families.

The two most common types of chest wall deformity are:

  • Pectus excavatum, also known as funnel chest or concave chest, occurs when the breastbone pushes inward. Children with this type of deformity appear to have sunken chests. Pectus excavatum is the most common type of chest wall deformity, affecting 1 out of every 300 to 400 children and three times as many boys as girls.
  • Pectus carinatum, also known as pigeon chest or raised chest, is a condition where the breastbone and ribs protrude. For some children, both sides of the chest stick out, but for others, one side of the chest may protrude more than the other side. The condition affects about 1 in every 1,500 children and is more common in boys than girls.

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Chest wall deformities often first become noticeable early, when a child is 1 or 2 years old. The deformity may be mild at first and become more severe during puberty, when a child’s bones and cartilage are growing rapidly.

Children with a chest wall deformity may have no symptoms at all, other than feeling self conscious about their appearance. However, some children experience difficulty breathing during exercise and are prone to respiratory infections and asthma.

Children with either type of chest wall deformity are at increased risk of developing scoliosis.

Depending on the type and severity of the deformity, chest wall deformities are often treated with surgery, a brace or no treatment at all.

Surgeons used to recommend surgery for children as young as 4, an age when bones are softer and easier to reposition. But too often, the condition would return, especially during growth spurts. Now, doctors often recommend waiting or not performing surgery at all. If they do operate, surgeons generally prefer to wait until the child reaches adolescence, after most of their growth spurts have happened.

How we care for chest wall deformities

The General Surgery Program at Boston Children’s Hospital is one of the largest pediatric surgery programs in the world. We perform more than 4,000 surgical procedures and care for an average 8,600 children each year.

We work closely with the Division of Pulmonary and Respiratory Diseases to evaluate and treat children with chest wall deformities that interfere with breathing.

10 common question about Chest Wall Deformities

1Can scoliosis cause chest deformity?
The relationship between anterior chest wall deformity and scoliosis is most clear in patients with Marfan syndrome. ... The causes of anterior chest wall deformity and scoliosis remain unclear, although unbalanced cartilage growth has been proposed as a potential cause of both.
2What is pectus excavatum deformity?
Pectus excavatum is a structural deformity of the anterior thoracic wall in which the sternum and rib cage are shaped abnormally. This produces a caved-in or sunken appearance of the chest. It can either be present at birth or develop after puberty.
3What does it mean if your chest sticks out?
Pectus carinatum is a rare chest wall deformity that causes the breastbone to push outward instead of being flush against the chest. It is also known as pigeon chest or keel chest. ... In cases of pectus carinatum, this cartilage grows abnormally, causing unequal growth in the areas where the ribs connect to the sternum.
4Can you fix a deformed rib cage?
If your rib cage is only slightly uneven, you may be able to improve your condition with repeated stretching and exercise. More serious cases of rib cage unevenness may need to be fixed surgically. Sometimes a custom brace can correct your rib cage.
5Does scoliosis affect the chest?
If left untreated, thoracic scoliosis can cause your chest to deform; as the spine becomes more and more twisted, so does the chest. ... Scoliosis patients may also experience chest pains and muscle spasms, and in very severe cases the patient's lungs and heart may be affected, leading to respiratory problems.
6Can scoliosis cause chest wall pain?
Back pain may occur and is generally muscular in nature, and it will often respond to a therapy program. Adult idiopathic scoliosis and degenerative scoliosis have long been thought to lead to shortness of breath and chest pain.
7Has anyone died pectus excavatum?
Of these 62 patients, 17 were 65 years or older and appeared to have died of causes unrelated to pectus excavatum, the oldest being 91 years. ... One of the 6 died in 1947 because of complications from pectus repair. No autopsied patient with pectus excavatum died between the ages of 5 and 14 years.
8Does pectus excavatum get worse with age?
It may get worse with age. Some people think that the cartilaginous ribs grow unevenly, pushing down the breastbone. Some patients with problems of bones and cartilage (Marfan's syndrome) can have a higher risk of pectus excavatum.
9Is sunken chest dangerous?
Mild cases might be barely noticeable. But severe pectus excavatum can cause a deep hollow in the chest that can put pressure on the lungs and heart, causing: problems tolerating exercise. limitations with some kinds of physical activities.
10Is pectus Carinatum life threatening?
Pectus, while typically not life-threatening, can affect your child's quality of life, and in some cases their heart and lung function. Our doctors are experts in chest wall deformities.

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