Chest wall deformities, or abnormal development and appearance of the chest, can vary from mild to severe. These deformities are considered to be congenital and may be apparent at birth or later in childhood. Regardless, the severity of the deformity usually progresses rapidly during puberty. A variety of anomalies are described however the most common are pectus excavatum (sunken chest or funnel chest) or pectus carinatum (pigeon chest). Less common types of chest wall abnormalities including Poland’s syndrome, Jeune’s syndrome, and defects of the ribs and sternum.

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CWD Guidebook225x225 75Interactive patient guidebook about Chest Wall Deformities complete with text, illustrations and multiple videos produced by UCSF Pediatric Surgery. (Free, iPad only)

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Pectus Excavatum

Pectus Excavatum

Pectus excavatum is characterized by a depression in the sternum, typically the lower half of the sternum. This is a result of abnormal and unequal growth of the costal cartilages, that connect each rib to the sternum. Rather than growing flat along the chest wall, the costal cartilages grow posterior or toward the child’s back. This pattern of growth pushes the sternum back, and prevents it from lying flat, giving the chest a sunken appearance. 

For more information read our Pectus Excavatum page.

Pectus Carinatum

Pectus Carinatum

Pectus carinatum is characterized by a protrusion of the sternum that occurs as a result of an abnormal and unequal growth of the costal cartilage connecting the ribs to the sternum. Rather than growing flat along the chest wall, the costal cartilages grow outward pushing the sternum forward. 

For more information read out Pectus Carinatum page.

Other types of chest wall deformities

Jeune's Syndrome is a form of congenital dwarfism that leads to a chest wall deformity. In Jeune’s syndrome the chest is extremely small. The ribs are often abnormal, broad, short and irregularly joined to the costal cartilages and sternum. This produces a small bell-shaped, inflexible chest cavity, which doesn't grow well and makes breathing difficult. Symptoms may begin in the newborn period, up to 4–5 years of age and can range from mild to severe. The most severe form may make breathing very difficult and the child may require help from a mechanical ventilator.

Poland Syndrome consists of a spectrum of abnormalities of one side of the chest including the absence of the pectoralis muscle(s), under development of breast tissue and areola, rib abnormalities and, in some cases, inadequate development of the arm, hand, and fingers of the same side. The right side of the body is affected twice as often as the left. It is not known how many individuals are affected by Poland syndrome, since mild cases may go undiagnosed. Poland syndrome does seem to affect males more commonly than females. 

Primary rib anomalies can be the cause of other types of chest wall deformities. There are 12 pairs of ribs that connect to the vertebra in the back and to the sternum on the front of the chest, by segments of cartilage. Rib abnormalities are variable and include extra or absent ribs, and partially developed or fused ribs. 

Other chest wall deformities are the result of abnormalities in the growth and development of the sternum.