What is Pigeon Chest?

What Is Pigeon Chest?

Pigeon Chest, also known by the medical name Pectus Carinatum, is a congenital condition in which the breastbone protrudes from the rest of the chest. It is moderately rare and usually only becomes noticeable during puberty. Most people will not experience significant medical complications as a result of this condition; with the physical appearance generally being the most significant feature.

However, effective treatment methods are available. This article will explore the current information available about pigeon chest, its prevalence and potential treatment methods. 

Why Is It Called Pigeon Chest?

The name pigeon chest refers to the jutting portion of the breastbone, which in severe cases can make the chest look bird-like. This condition may also be referred to by the common name Keel Chest, which may refer to either the keel of a ship, or again be referring to the breastbone of a bird.

The former suggestion appears more likely, given that the medical name pectus carinatum comes from the Latin for “chest keel”, referring to the keel of ancient Roman ships.[1]

When Was Pigeon Chest First Discovered?

The ancient Greek physician Hippocrates (460-370 BC) was one of the first to describe pigeon chest, stating that “The chest becomes sharply pointed and not broad and becomes affected with difficulty in breathing and hoarseness.” Even over two thousand years later, it can clearly be recognized that this description is referring to pigeon chest. 

What Causes Pigeon Chest?

As pigeon chest is a congenital condition, it is present before birth. The exact cause of this disease remains unknown. However, having family members with pigeon chest increases the chance of a particular person also having it.[2]

Environmental factors may play a role in determining the incidence of pigeon chest.[3] Some syndromes also increase the chance of having this condition, including:

• Morquio syndrome
• Poland's syndrome
• Ehlers-Danlos syndrome
• Osteogenesis imperfecta
• Trisomy 18 or 21
• Homocystinuria
• Scoliosis, and
• Coffin-Lowery syndrome [4]

Furthermore, pigeon chest is four to five times more common in boys than girls.[3,5] 

Although the predisposition toward pigeon chest is present before birth, it is not usually obvious until puberty, when it becomes more apparent due to the rapid growth spurts that occur from ten years of age through to the teen years.

In children with pigeon chest, an overgrowth of the cartilage forming the breastbone causes it to protrude, resulting in the main characteristic feature of this condition.

Pectus carinatum does not develop identically in all people; cases may range from very mild to severe. There may also be differences in which region of the chest is protruding.

If the upper breastbone is jutting out, this is known as Chondromanubrial prominence and is usually a more severe form of the condition.[6] If the lower or middle regions of the breast protrude, then this is known as Chondrogladiolar prominence and is less severe in most patients.

The protrusion may also be symmetric (to an equal extent on both sides of the chest) or asymmetric. Another common side effect of pigeon chest is costal flaring or rib flaring, where the bottom part of the rib cage also pushes outward. 

What Are the Signs of Pigeon Chest?

Due to the wide range in severity and presentation, the signs or symptoms of pigeon chest may vary. The most obvious and characteristic sign is protrusion or irregularities in the breastbone region. However, other signs which may early warning of pigeon chest include:

• Shortness of breath or having trouble breathing
• Poor posture
• Hooked or rounded shoulders
• Curving of the spine
• Fast heart rate or chest pain (in severe cases)
• Routinely feeling tired or fatigued

It should be noted that in most cases, pectus carinatum does not significantly affect the function of the lungs or heart. For many people, the cosmetic appearance of this condition will be the main negative factor.[1]

How Can Pigeon Chest Be Fixed?

Pigeon chest is unlikely to improve by itself; however, effective treatment methods for this condition are available. The use of an orthotic pectus carinatum brace is generally recommended as the first line of treatment.[7]

This involves wearing a lightweight compression brace for an extended period (usually 23-24 hours per day for 6-12 months). Over time, this retrains the breastbone cartilage to grow in the correct shape, thus correcting the outgrowth.

Treatment can be reduced or stopped once the protrusion has been fixed and the breastbone region stops growing. Clinical studies have shown that pigeon chest braces are quite effective at treating this condition,7 with only 2-11% of patients not responding to this method of treatment.

In the most severe cases of pigeon chest or the rare instances where bracing treatment fails, minimally-invasive surgery methods are available to correct the breastbone protrusion.

To get the best results from a pectus carinatum brace, it must be specific to the condition and be worn as prescribed by your medical professional. If the brace is not worn routinely, then the treatment will not be as effective.

Custom-made braces, such as those manufactured by Dakota Brace, provide a perfect fit, ensuring that the treatment process is as comfortable as possible. These braces are 3D printed to exactly fit the patient’s chest shape, providing a rapid turnaround time without compromising on quality.

They are also of a much higher quality compared to other generic braces which are available on the market. Braces are available for treating pectus carinatum alone, or pectus carinatum in combination with rib flare.

Even better, our team of certified clinicians can guide you through the entire process remotely* in a way that fits around your schedule.

*Note: You will need access to an iPhone X or later to do your initial scan. 

Conclusion 

Are you ready to restore your child’s health and confidence? Or would you like more information about how to fix pigeon chest? Click here to get a free consultation and $75 off your first order with Dakota Brace, and get evaluated for either our Custom Pectus Brace (The Dakota Brace) or our Custom Pectus & Two Rib Flare Brace (The Bison Brace).

References

1. Özkaya, M., & Bilgin, M. (2018). Minimally invasive repair of pectus carinatum: a retrospective analysis based on a single surgeon’s 10 years of experience. General Thoracic and Cardiovascular Surgery, 66(11), 653-657.
2. Shamberger, R. C. (1996). Congenital chest wall deformities. Current Problems in Surgery, 33(6), 469-542.
3. Cobben, J. M., Oostra, R. J., & van Dijk, F. S. (2014). Pectus excavatum and carinatum. European Journal of Medical Genetics, 57(8), 414-417.
4. Croitoru, D., & Nuss, D. (2004). Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med, 15, 455-471.
5. Abdullah F, Harris J (2016) Pectus excavatum: more than a matter of aesthetics. Pediatr Ann, 45:e403–e406.
6. Frey, A. S., Garcia, V. F., Brown, R. L., Inge, T. H., Ryckman, F. C., Cohen, A. P., ... & Azizkhan, R. G. (2006). Nonoperative management of pectus carinatum. Journal of Pediatric Surgery, 41(1), 40-45.
7. Emil, S. (2018). Current options for the treatment of pectus carinatum: When to brace and when to operate?. European Journal of Pediatric Surgery, 28(04), 347-354.