Pediatric Chest Wall Disorders Program

Chest wall disorders can affect your child’s heart and lungs. At MU Health Care, our expert team is dedicated to managing and correcting these conditions in kids, teens and adults.

We have a special clinic just for kids with chest wall disorders, the only one of its kind in mid-Missouri. Whether your child was born with a disorder or developed one during adolescence, we can help. Our board-certified specialists partner with other experts to develop a complete care plan for your child.

Your child’s care team may include:

Pediatric surgeons: Offer many minimally invasive and open surgery, as well as innovative treatment options.
Pediatric surgery nurse practitioners: Help manage your child’s care plan and provide education for the entire family.
Pediatric cardiologists: Care for heart-related issues caused by malformations.
Pediatric pulmonologists: Can address shortness of breath and other lung-related issues.
Physical and occupational therapists: Guide your child through exercises that can help strengthen muscles and improve posture.
Pediatric neurologists: Can help when chest wall disorders pinch nerves and cause pain, as well as help evaluate the effects of our innovative nerve freezing.

Symptoms of Chest Wall Disorders

Chest wall disorders can affect your child’s appearance in different ways. Warning signs of a chest abnormality include:

A “sunken chest”
A breastbone that pushes forward, called a “pigeon chest”
A bell-shaped or fan-shaped chest
An uneven, or asymmetrical, chest

Many chest wall disorders don’t cause symptoms, but some can cause:

Chest pain
Heart palpitations
Shortness of breath
Inability to exercise for long periods of time
Dislocated collarbones
Poor body image or low self-esteem

Getting Help for Chest Wall Disorders

If your child has these signs or symptoms of a chest wall disorder, contact your child’s primary care provider. Or you can reach out to our team directly.

Types of Chest Wall Disorders

At Children’s Hospital, we provide specialized care for common to highly complex chest wall disorders in kids and teens, including:

Pectus excavatum: Also called “sunken chest” or “funnel chest,” happens when chest cartilage pushes the breastbone and ribs inward.
Pectus carinatum: Also called “pigeon chest,” occurs when chest cartilage pushes the breastbone forward.
Poland syndrome: A condition in which your child’s chest wall muscles and ribs don’t fully develop or never develop.
Slipped rib: Occurs when a lower rib moves out of place and pinches the nerve underneath it.
Congenital rib abnormalities: Structural issues with the ribs that are present at birth.
Jeune syndrome: A narrow, bell-shaped chest that causes difficulty breathing.
Jarcho-Levin syndrome: A short torso and “fan-like” ribcage that also affects breathing.

How We Diagnose Chest Wall Disorders in Children

When you come to our clinic, you’ll find a team that is committed to helping young patients of all ages with chest wall disorders.

What to Expect During Your First Visit

For your first appointment at our kid-friendly clinic, you will meet with a pediatric surgeon or advanced practice nurse. We’ll go over your child’s medical, surgical and family history and perform an examination. After the exam, we may provide a diagnosis and discuss your treatment options.

Additional Testing Before Treatment

After your first visit, we might order tests to understand how your child’s condition affects their heart and lungs. Your child’s tests may include:

Echocardiogram: An ultrasound of the heart.
Computed tomography (CT) scan: Provides detailed images of structures inside your child’s chest.
Xenon gas magnetic resonance imaging (MRI): Shows how your child’s chest wall moves and affects other organs.
Pulmonary function tests (PFTs): Indicate how well your child’s lungs work.
Cardiopulmonary exercise testing (CPET): Measures your child’s heart and lung function during exercise.
3D structural camera: Creates a detailed model of your child’s chest to help plan treatment.

With results from these tests, you will meet our team of experts from various fields who will build a personalized treatment plan based on your child’s specific condition. Before treatment, we’ll explain next steps and answer any questions you may have.

How We Treat Pediatric Chest Wall Disorders

Conditions like pectus carinatum may be corrected without surgery. However, complex disorders like pectus excavatum may require surgery.

Nonsurgical Treatments

We may use the following approaches to treat your child’s chest wall disorder:

Pectus bracing: A lightweight, custom-fitted brace applies gentle pressure to reshape the chest wall.
Vacuum bell: A wearable device uses suction to lift a sunken chest in the most minor disorder.
Physical therapy: Helps strengthen chest muscles and improve posture.

Minimally Invasive Surgery

Our specially trained pediatric surgeons can treat many chest wall disorders with minimally invasive techniques, including:

Minimally invasive repair of pectus carinatum: Remodeling a protruding breastbone (pigeon chest).
Minimally invasive repair of pectus excavatum (MIRPE) Nuss procedure: Used to fix sunken chests.

Open Surgery

Certain complex chest wall disorders may require a modified Ravitch procedure. This traditional, or open, surgery involves remodeling the chest wall and removing extra chest cartilage as needed. Our surgeons are highly skilled in treating different disorders using this technique.