Pectus excavatum is a common chest wall deformity characterized by a sunken appearance of the sternum, or breastbone. This structural anomaly gives the chest a caved-in or “funnel chest” look. Visual identification is a primary step for those seeking information about this condition through images.
Identifying Pectus Excavatum Visually
The most distinctive visual feature of pectus excavatum is the depression of the sternum. This “caved-in” appearance can range from a subtle indentation to a deep, noticeable concavity in the center of the chest. The lower portion of the sternum is most commonly affected, though a broader concavity involving the upper costal cartilages is also possible. This inward growth of the breastbone creates a hollowed-out space.
When observing pictures, look for the overall chest shape, specifically how the sternum recedes inward. The depth and location of this depression are key indicators. Ribs connected to the sternum may also angle differently, contributing to the sunken effect. In some cases, the lower ribs might protrude, known as rib flaring, which further accentuates the sternal depression.
Common Visual Variations
Pectus excavatum presents a wide spectrum of visual appearances. The depth of the sternal depression can vary, categorizing cases as mild, moderate, or severe. A mild case might show only a slight dip, while a severe presentation can involve a deep indentation that appears to “scoop out” the chest.
Beyond depth, the symmetry of the deformity is another common variation. Some individuals exhibit a symmetrical depression, centered and evenly distributed across the chest. In contrast, asymmetrical pectus excavatum involves a depression more pronounced on one side, often causing the sternum to rotate or tilt. This asymmetry can make the chest appear uneven, with one side seemingly wider or more affected than the other. Variations also include the extent of sternal involvement, ranging from a narrow, localized indentation to a broad, extensive depression.
Related Visual Cues and Associated Features
Beyond the primary sternal depression, other visual signs can accompany pectus excavatum, noticeable in photographs. One such feature is flared ribs, where the lower ribs appear to stick out or protrude, enhancing the visual effect of the sunken chest. This rib flaring can occur on one or both sides and may sometimes seem more prominent than the sternal indentation itself.
Another associated visual cue is scapular winging, where the shoulder blades protrude noticeably from the back, appearing like wings. This is observed when viewing from behind, with the shoulder blades not lying flat against the ribcage. Postural changes are also often observed, such as rounded shoulders or a hunched-forward stance. This “pectus posture” can make the upper back appear hunched and the shoulders slump forward, visually accentuating the chest deformity.
What Pictures Cannot Tell You
While pictures offer valuable visual insight into pectus excavatum, they cannot convey the complete clinical picture. Solely relying on visual inspection cannot determine the functional impact on internal organs. For instance, images do not reveal whether the heart or lungs are compressed or displaced by the inward sternum.
Pictures also cannot indicate the presence or severity of associated symptoms like shortness of breath, chest pain, or exercise intolerance. These functional limitations require medical evaluation and diagnostic tests beyond visual assessment. Therefore, while visual identification is a useful first step, it is not a substitute for a professional medical consultation to understand the full scope of the condition. Medical professionals utilize additional tools, such as imaging scans, to assess internal effects and overall severity.