Pigeon chest, correctly known as pectus carinatum or keel chest, is a deformity of the chest wall that affects a small percentage of the population and varies in severity. Unlike pectus excavatum, where the sternum is sunken, in this condition, the sternum protrudes outward.
What Is pectus carinatum?
Pectus carinatum is characterized by abnormal development of the sternum and the adjacent ribs, causing the front part of the chest to protrude forward in a keel-like shape, resembling the bow or stern of a ship.
This condition can occur in isolation or as part of a genetic syndrome.
Although it is usually not painful, it can cause chest discomfort, difficulty breathing during exercise, or self-esteem issues due to its cosmetic impact.
There are two main types of pigeon breast:
- Lateral pectus carinatum: The sternum protrudes asymmetrically and more prominently on one side of the chest.
- Anterior pectus carinatum: The sternum protrudes uniformly forward, giving a symmetrical appearance.
This condition is typically detected during childhood or adolescence and may become more noticeable during periods of rapid growth, such as puberty.
Causes of Pectus Carinatum
The exact causes are not always clear, but common contributing factors include:
- Genetic predisposition: There is a strong link between pectus carinatum and family history. Having a close relative with the condition increases the risk.
- Abnormal growth of costal cartilages: In many cases, pectus carinatum is caused by excessive growth of the cartilages that connect the ribs to the sternum, pushing the sternum outward.
- Genetic syndromes: Some hereditary conditions have been linked to the development of this disorder. For example, Marfan syndrome, a connective tissue disorder that affects bone and joint development; Noonan syndrome, which can cause various malformations or other congenital conditions such as scoliosis or even some heart conditions.
- Nutritional deficiencies: Though rare today, vitamin D deficiency or rickets may contribute to abnormal bone and cartilage development.
Keeled thorax
Treatment depends on the severity of the condition, associated symptoms, and the patient’s preferences. Options include non-surgical and surgical interventions.
Non-surgical treatments include the use of an orthotic brace, which is an effective option for children and adolescents whose bones and cartilage are still developing. This device applies pressure to the sternum and helps reshape the chest wall over time. Physical therapy is also an option, involving strengthening and postural improvement exercises that can complement the use of the brace, help reduce discomfort, and improve breathing capacity.
Surgical treatment is used in severe cases or when conservative treatments have not been effective. Common procedures include the Ravitch technique, which involves making an incision in the chest, removing the affected costal cartilages, and repositioning the sternum in its correct place, and the Abramson technique, a minimally invasive procedure in which a metal bar is inserted beneath the sternum to apply pressure and gradually reshape the chest.
The emotional impact of pectus carinatum can be significant, especially during adolescence. Psychological therapy can help patients manage self-esteem and social anxiety issues related to the condition.
With proper treatment, most patients with pectus carinatum experience significant improvements in physical appearance and respiratory function.
At the ABC Medical Center’s Pediatric Center, we can provide you with specialized care. Contact us today!
Fuentes:
MedlinePlus, Stanford Medicine, Kids Health
