Pectus Carinatum

What is pectus carinatum?

Pectus carinatum, also known as pigeon chest, is a deformity of the chest wall in which the breastbone and ribs are pushed outward. The condition occurs in about 1 out of 1,500 children and more frequently in boys. It’s often asymmetrical, with one side of the chest affected more than the other. In addition, some children have pectus carinatum on one side of the chest and an indentation called pectus excavatum on the other side of the chest.

Pectus carinatum often worsens as a child grows, particularly when the child reaches puberty. Approximately 15 percent of children with pectus carinatum develop scoliosis.

There are two basic types of pectus carinatum:

  • chondrogladiolar prominence, also known as chicken breast, accounts for nearly 95 percent of cases of pectus carinatum.
  • chondromanubrial prominence, also known as pouter pigeon breast, a rare type of pectus carinatum that can be more complex to treat

What are the symptoms of pectus carinatum?

The symptoms of pectus carinatum change as a child grows and matures. In infancy, symptoms can include:

  • a hollow depression in the chest that may be broad and shallow, deep and narrow, or irregular
  • more rapid breathing than normal

In older children, symptoms can include:

  • shortness of breath upon exertion or exercise
  • chest pain
  • a lateral curvature of the spine
  • absence of the curve of the upper back
  • hooked shoulders
  • a broad thin chest

What causes pectus carinatum?

There is no known cause for pectus carinatum. Some studies investigating a genetic component are underway. Although the majority of children with pigeon chest don't involve a family history of the condition, enough do to warrant suspicion that genes may play a significant role.

How we care for pectus carinatum

The Pectus and Chest Wall Treatment Program at Boston Children’s Hospital evaluates and treats infants, children and young adults using state-of-the-art operative methods to improve the quality of life for each child entrusted to our care. We base our treatment of pectus carinatum and other chest wall deformities on the severity of the condition. For mild cases of pectus carinatum, we recommend not doing anything to try to fix it. If your child’s condition is a bit more severe, we may treat them with a customized brace that gradually reshapes the chest. In rare cases, your child’s doctor may recommend surgery.

If your child develops scoliosis, the Spine Division at Boston Children’s is one of the nation’s foremost pediatric treatment and research centers.