Pectus Carinatum | Diagnosis & Treatments

How is pectus carinatum diagnosed?

Your child's doctor can diagnose pectus carinatum during a physical examination.

The physician calculates the depth of the chest from front to back using x-rays of the chest to determine if the diameter is longer than average. If it is, that means your child has pectus carinatum.

X-rays also help the doctor determine the presence of scoliosis or any other abnormalities of the bones.

Other tests your child's doctor might recommend include:

  • electrocardiogram (ECG or EKG): a test that records the electrical activity of your child's heart, shows abnormal rhythms, and detects heart muscle stress
  • echocardiogram (echo): a test that evaluates the structure and function of your child's heart by using sound waves recorded on an electronic sensor, which produce a moving picture of the heart and heart valves
  • computed tomography (CT) scan: a test that is used to establish the level of severity of the condition and also help the surgical team plan for the procedure

How is pectus carinatum treated?

If your child has a mild case of pectus carinatum, their doctor may recommend not doing anything to treat it. For more noticeable cases, doctors typically recommend bracing. In the most severe cases, surgery may be necessary.

How does bracing work?

Bracing can treat mild to moderate cases of the condition in young children whose chests are still flexible. Once the chest bones are completely formed, bracing becomes much less effective. In this case, or if your child cannot or does not want to follow the rigorous bracing schedule, your child’s doctor may recommend a surgical procedure. A brace is made specifically for your child based on your child's measurements and the shape of the protrusion. It may need to be adjusted periodically as your child grows. The brace applies pressure to the protruding breastbone and cartilage and gradually reshapes the chest wall.

Your child will need to wear the brace at home and when sleeping at night. The process of correction will often take about a year. It's important to remember that the length of the process occurs is directly related to how long and how consistently your child wears the brace.

What is the surgical procedure to correct pectus carinatum?

Pectus carinatum can be surgically repaired in an operation called the Ravitch. In this procedure, the surgeon makes an incision in your child's chest wall, removes the cartilage wedged between the ribs and sternum, then reshapes and repositions the freed-up sternum.

A bar is left in the chest wall to maintain the correct shape for six months, during which time your child has to refrain from activities that might involve a collision, like football.