01

Pectus Carinatum (raised chest)

Pectus carinatum (PC), or raised chest, is a genetic disorder of the chest wall in which the sternum and ribs protrude. It affects more boys than girls, and typically becomes more pronounced as the child grows. It may not be noticeable until puberty. In most cases, the main concern is cosmetic, although patients can experience restricted pulmonary function, especially during exercise, as well as chest pain, tachycardia and fatigue.

02

Pectus Excavatum (sunken chest)

Pectus excavatum (PE) is the most common chest wall deformity affecting one in 500 children. The sternum and several ribs grow inward, creating a caved in appearance. More common in boys than girls, it is noticeable in infancy but becomes more pronounced by adolescence. PE can cause body image issues, chest wall restriction and decreased thoracic volume, shortness of breath when exercising, chest pain, tachycardia, coughing or wheezing, and fatigue. While most patients with PE do not have other musculoskeletal disorders, PE can be associated with Marfan syndrome, Poland syndrome and scoliosis.

03

Poland Syndrome

Patients with Poland syndrome exhibit underdeveloped or missing chest wall muscles on one side of the body and absence of the sternal portion of the chest muscle. More common in boys, it typically occurs on the right side of the body. The condition becomes more noticeable as children approach puberty. Shriners Hospitals for Children — Northern California evaluates patients with suspected Poland syndrome, ruling out other disorders. CT scan, MRI and X-rays may be used to determine the severity of the asymmetry. When other conditions are present, which can include pectus excavatum (sunken chest), the team monitors and addresses both conditions. The Chest Wall team works with the hospital’s plastic surgeons to correct cosmetic differences once teens are fully developed. For boys, surgeons can add a prosthesis to replace a missing pectoral muscle. A breast implant is an option for girls. Physicians can refer patients as young as toddlers for suspected Poland syndrome. The Chest Wall team will monitor these patients as they grow and guide the family if they would like cosmetic correction.