Pigeon chest

Pigeon chest (pectus carinatum) is a condition in which the breastbone and rib cage are pushed forwards by overgrowth of the costal cartilage. This creates a bump in the middle of the chest that resembles the chest of a bird such as a pigeon. If necessary, this condition can be treated with a brace or an operation.

What is a pigeon chest?

A pigeon chest (pectus carinatum) arises because there is an overgrowth of costal cartilage alongside the breastbone. This pushes the breastbone forwards. The pigeon chest is almost always already present at birth but often worsens during a period of rapid growth, such as a growth spurt. The pigeon chest can occur high or low on the chest and on one or both sides of the rib cage.

Why the cartilage in some people grows too much is not known. In some cases, it seems to develop due to the use of medicines, lung diseases, or chest operations. Heredity and the presence of other conditions, such as scoliosis, heart defects, and connective tissue disease, also play a role.

A pigeon chest occurs in about 1 in 1600 people and is more common in boys than in girls. This is less common than funnel chest, in which the rib cage grows inwards.

Complaints

Complaints as a result of a pigeon chest vary from mild to severe. In mild cases, the bump (also called a protrusion) can be small and cause little to no complaints. In people with a severe pigeon chest, the protrusion is clearly visible. This can lead to various problems, such as:

• Feelings of discomfort or embarrassment about appearance.
• Difficulty finding well-fitting clothing.
• Breathing problems, especially during exertion.
• Chest pain, particularly during prolonged activity.
• Reduced physical performance and endurance.

Treatment

Treatment of a pigeon chest is in many cases not immediately necessary. If there are severe physical or psychological complaints, there are several treatment options. Depending on the severity of the complaints, the patient has the choice between a conservative or surgical treatment.

• Conservative treatment. Wearing a custom-made brace. This gradually pushes back the protrusion so that it slowly decreases. In addition, there are exercises to improve the muscle strength and flexibility of the chest.
• Surgical treatment. The rapidly growing cartilage is removed, and the breastbone is moved backwards (Ravitch operation). Another method is the Abramson operation, in which the surgeon places a metal bar in the chest that pushes back the protrusion. 2.5 to 3 years later, the bar is removed again.