Chest Wall Deformities Symptoms & Causes

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In-Depth

What are characteristics of funnel chest and pigeon breast?

Funnel chest is a depression or hollow caused when the breastbone, the bone in the middle of the ribcage, is pushed abnormally inward.

It's either congenital (present at birth) or it develops within months of birth.

  • Mild cases, on occasion, correct themselves, usually by the time a child is 3.
  • In moderate and severe cases however, funnel chest may grow progressively worse and require surgery.

True funnel chest exists when the chest remains sunken even when your child exhales or is resting.

  • When a child with funnel chest is examined either sitting or lying on the back, face up, the hollow in the chest is unchanged or rigid.
  • For those children who undergo surgery, normal breathing returns.
  • In fact, the outlook is excellent for 90 to 95 percent of those who are treated for this problem; for about one in 30 children, a second operation may be required.

Pigeon Breast - Pigeon breast is caused when the breastbone is pushed outward.

Girls usually develop pigeon breast at a somewhat younger age then boys, who do not develop the condition until adolescence, usually from 11 to 14 years of age.

As with funnel chest, this condition may interfere with your child's physical health. The deformity often increases in severity each year until a child reaches full growth. Scoliosis is associated with this condition and becomes more controllable after treatment.

Surgery can correct pigeon breast and the outlook for children who have the operation is excellent.

What causes chest wall deformities?

We don't know. Some studies investigating a genetic component are underway. Although the majority of cases don't involve a family history, there are many that do—enough to warrant the suspicion that genes play a significant role. The genetic story is likely to be complex, though.

If pigeon breast is present during infancy, it may be associated with premature fusion of the segments of the breastbone, a short wide breastbone, and congenital heart disease.

When do these deformities first appear?

Doctors often see both deformities in newborns and during early childhood. Other times, though, it may not be apparent until the child is 9 or 10. It's rare for either excavatum or carinatum to show up after that. The typical course is from mild to more severe, with growth spurts contributing most to severity.

What are the symptoms of chest wall deformities?

In infancy, symptoms of funnel chest can include:

  • frequent lingering colds that often develop into pneumonia
  • a hollow depression in the chest that may be broad and shallow, deep and narrow or asymmetric
  • difficulty breathing

In older children, symptoms of funnel chest can include:

  • breathing difficulty upon exertion or exercise
  • chest pain
  • frequent respiratory infections
  • some children have a lateral curvature of the spine, absence of the curve of the upper back, hooked shoulders and a broad thin chest

Symptoms of pigeon chest include:

  • difficulties playing and exercising
  • tenderness and intermittent pain in the area of overgrown cartilage

The symptoms of chest wall deformities may resemble other conditions or medical problems. Always talk to your child's physician for a diagnosis.

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