Difference between funnel chest and pigeon chest

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on September 01, 2024
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Pectus excavatum and pectus carinatum are both types of deformities of the anterior chest wall, with pectus excavatum being the most common deformity, accounting for 90% of all anterior chest wall deformities; the incidence of pectus carinatum is only one-fifth to one-sixth of that of pectus excavatum. The shapes of pectus excavatum and pectus carinatum are also completely different. Pectus excavatum appears as if a funnel were placed on the chest, with the funnel receding backward and downward. Therefore, patients with pectus excavatum, when lying down, can observe a depression in the front of their chest, which is even capable of holding a cup of water placed within this funnel-like depression. On the other hand, the deformity in pectus carinatum protrudes forward. One caves inward while the other protrudes forward, thus these two shapes are completely opposite.

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The difference between rib flare and pigeon chest

The main difference between rib flaring and pigeon chest is that the former is caused by soft tissue pathology around the thoracic cage, while the latter is due to a bony deformity of the thoracic cage. Patients with rib flaring often have very thin muscles around the thoracic cage due to poor posture, such as excessive abdominal tucking or long-term dieting, which leads to a very prominent thoracic cage when standing. Pigeon chest, on the other hand, is due to severe malnutrition during the patient's growth and development phase, which leads to the anteroposterior diameter of the thoracic cage being larger relative to the mediolateral diameter. In this case, the patient will exhibit a noticeably protruding thoracic cage, especially at the front.

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Late-stage symptoms of rickets pigeon chest

If a child has developed rickets and has already shown deformities such as pigeon chest, this indicates that the child is in the later stages of the active phase, meaning that a clear skeletal deformity has occurred. As the child ages, there may also be deformities in the lower limbs as the child begins to stand and walk, such as bowlegs or knock-knees, or a K-shaped leg deformity. Gradually, the child will enter the sequelae phase, which is more common in children over the age of two. In infancy, due to severe rickets, different skeletal deformities may remain without any other clinical symptoms. Blood biochemical indicators are normal, and X-ray examinations will show that the pathological changes at the epiphyseal ends of the bones have disappeared. Generally, no treatment is required, but if there are obvious deformities, corrective treatment may be necessary.

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Causes of pectus carinatum in children

The causes of pigeon chest in children mainly include two aspects, one is congenital and the other is acquired. Among them, congenital pigeon chest and funnel chest both involve hereditary factors. Additionally, if the central attachment point of the diaphragm in a child is underdeveloped, it can also cause pigeon chest, which is also a congenital cause. Moreover, the acquired causes mainly include malnutrition and some specific thoracic diseases. Malnutrition is often related to rickets. Acquired thoracic diseases involve some diseases of the thoracic cavity, for example, pyothorax leading to flat chest, chest wall deformity, as well as some congenital heart diseases, heart enlargement, which then compresses the sternum causing it.

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What department should I go to at the children's hospital for chickenpox?

If children have pectus carinatum and need treatment, it is necessary to check if the children's hospital has a specialized thoracic surgery department. If there is a pediatric thoracic surgery department, one can make an appointment there. Generally, for mild cases of pectus carinatum, children do not need surgery and can undergo conservative treatment, such as having a custom chest orthosis made. Wearing the chest orthosis can correct the condition. If the pectus carinatum is severe, and the child is over four years old, then surgery can be considered in the thoracic surgery department. Therefore, for pectus carinatum, appointments need to be made with the thoracic surgery department at a children's hospital.

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How to recover from pigeon chest in children?

Childhood pectus carinatum is a common clinical condition, primarily caused by a deficiency in vitamin D leading to metabolic bone disease. Its characteristics are mainly manifested by the protrusion of the sternum and flattening of the chest walls on both sides. There are several treatment methods available: First, supplement children with calcium tablets and vitamin D, promptly administer these medications, and encourage exposure to sunlight and outdoor activities during the growth process, which is beneficial for bone calcium absorption. Additionally, the child should wear a brace specifically for pectus carinatum. The brace compresses the chest cavity, causing it to protrude upward. After wearing the brace for a period, the protruding chest can show improvement. If previous treatment methods are ineffective and severe sternal deformities still occur, surgical treatment at a specialized hospital may be necessary. In daily life, the child should be cautious about their posture and body position, avoiding rolling, bending, and similar actions as much as possible to facilitate a quicker recovery.