Pigeon chest, or pectus carinatum, is a chest wall deformity where the breastbone (sternum) and ribs protrude outward, giving the chest a prominent, sometimes bird-like, appearance.
Understanding Pigeon Chest
Pectus carinatum involves an outward bowing of the sternum, which can occur symmetrically or asymmetrically. The protrusion might affect the entire breastbone or be localized to specific sections. In some cases, one side of the chest may protrude while the other shows an indentation. For many, the condition is primarily a cosmetic concern.
Why Pigeon Chest Develops
The exact reason for pectus carinatum is not fully understood. However, it is often attributed to abnormal growth of the cartilage connecting the ribs to the breastbone, which pushes the sternum outward.
Although the condition can be present from birth, it typically becomes more noticeable during periods of rapid growth. This often occurs during adolescence and puberty, around 11 years of age or older.
Pectus carinatum can be present at birth (congenital), and a genetic component is often observed, with approximately 25% of affected individuals having a family history of chest wall deformities. While generally a standalone condition, it can be associated with certain genetic disorders, including Marfan syndrome, Ehlers-Danlos syndrome, and Noonan syndrome, which affect connective tissues.
Potential Health Impacts
While not typically causing severe health problems, pectus carinatum can lead to some physiological effects. Some individuals may experience mild respiratory issues, such as shortness of breath, especially during strenuous physical activity or exercise. This can be due to the chest wall being rigidly held outward, which may affect the efficiency of breathing and lead to reduced exercise tolerance. There is also an association with symptoms similar to asthma in some patients.
Beyond physical aspects, the visible nature of pectus carinatum can have a significant psychological and social impact. Individuals, particularly adolescents, may experience self-consciousness, body image issues, and anxiety due to the appearance of their chest. These emotional and social challenges can sometimes be the primary reason individuals seek treatment, even when physical symptoms are minimal.
Identifying and Managing Pigeon Chest
Diagnosis primarily involves a physical examination. A visual assessment of the chest is usually sufficient to identify the protrusion. In some instances, imaging techniques like X-rays, CT scans, or MRI may be used to assess the severity of the deformity and rule out other conditions.
For management, non-surgical options are often the first approach, especially for growing individuals. Bracing, using a dynamic compression orthosis, is a common and effective method. These custom-fitted braces apply continuous, gentle pressure to the protruding area of the chest, gradually reshaping it over time.
Braces are most effective when applied before or during a patient’s growth spurt and are typically worn for extended periods.
Physical therapy can serve as a supportive measure, focusing on improving posture, increasing chest wall flexibility, and strengthening muscles. While exercises alone may not fully correct the deformity, they can help improve the appearance and overall chest mechanics. For more severe cases, or when non-surgical methods are not effective or suitable, surgical correction may be considered. Procedures like the Ravitch procedure or modified sternal osteotomy involve reshaping or repositioning the breastbone. With appropriate treatment, the outlook for individuals with pectus carinatum is generally favorable.