Pectus carinatum (pigeon chest)

Pectus carinatum is commonly known as pigeon chest. It happens when part of your child’s breastbone is pressed outwards or raised up.


What is pectus carinatum (pigeon chest) and how will it affect my child?

Pectus carinatum (pigeon chest) is when part of your child’s breastbone is pressed outwards or raised up. It usually first develops during a rapid growth spurt, in children and adolescents aged 10 and older.

Pigeon chest develops differently in different people. It can push forward the top, side or bottom of the breastbone so that it sticks out. It can develop in the same way on both sides (symmetrical) or occur on just one side (asymmetrical). The breastbone can be stiff or flexible.

How common is it?

Pigeon chest is rare. It affects 1 or 2 children in a thousand and affects more boys than girls.


What causes pigeon chest?

We don’t know for certain what causes pigeon chest. One possible cause is when the tissue that connects the breastbone to the ribs grows too much.  Another cause might be when parts of the bone itself grow too much.  Sometimes it happens following open heart surgery.

Pigeon chest seems to run in families. But we don’t know for sure if it’s an inherited condition.

Sometimes pigeon chest develops as part of a rare genetic disorder. People with disorders including Marfan syndrome and Noonan syndrome may have pigeon chest as a symptom.


Are there any complications?

Most people with pigeon chest don’t have any other problems. Up to 1 in 10 people with chest deformities like pigeon chest may also have scoliosis.

If your child has pigeon chest as part of a genetic disorder like Marfan syndrome or Noonan syndrome, they will have it alongside a range of other symptoms.

Pigeon chest and body image

Because it affects the shape of their chest, some children and adults with pigeon chest may be unhappy with their body. This can have a big impact on their lives. Even if pigeon chest isn’t causing any physical problems, treatment may be recommended to improve your child’s self-esteem and quality of life.


What are the signs and symptoms?

Most children with pigeon chest do not have any symptoms, except that their chest sticks out. This usually starts to develop at the age of 10 or older.

Some people with pigeon chest may feel tenderness where the breastbone is raised.

Some may develop a rigid chest wall. They may experience breathlessness and find it harder to breathe, especially when they exercise.


How is pigeon chest diagnosed?

Pigeon chest can be diagnosed with a visual assessment. The doctor usually just needs to look at your child’s chest.

Some children may need an X-ray or CT scan, so that the doctor or surgeon can see how their breastbone is growing.

They may have tests to check whether their heart is working properly, and breathing tests to see how well their lungs are working.

They may have a blood test to rule out genetic causes such as Marfan syndrome and Noonan syndrome.


Will it get better by itself?

Pigeon chest is unlikely to get better by itself. In some mild cases, weightlifting and exercise can build muscles in the chest, which can help to mask the shape of the breastbone.


What is the treatment?

Mild cases of pigeon chest may not need treatment. When treatment is recommended, it’s usually for cosmetic reasons or to improve self-esteem and quality of life. It’s not usually carried out in children under the age of 10.

Orthotic treatment

Children with moderate to severe pigeon chest may have orthotic treatment. This means using special equipment to correct the shape of their chest.

Your child will wear a chest compression brace. This puts gentle pressure on the chest to change the shape and position of the breastbone, over time. The chest brace might be off-the-shelf, or custom made to fit your child.

Your child will need to wear the brace every day. Treatment may take up to 2 years depending on how old your child is, how stiff their breastbone is, and the severity of the pigeon chest. For the treatment to be effective, it’s important that your child wears the brace as directed by the orthotist. The more hours they spend wearing the brace, the more likely it is to be successful.

Surgery

If your child’s pigeon chest is more severe, they may need surgery.


Further information

There’s more information about pectus correction surgery on the Royal Brompton NHS Trust website.

Is treatment available in my area?

Not every part of the UK offers orthotic treatment or surgery for pigeon chest. You may have to travel to another area. Your doctor will refer you.

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Last medically reviewed: September 2019. Due for review: September 2022

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.