What Are the Types of Pectus Carinatum in Children? A Guide to Identifying Severity at Home

Introduction

Many parents, after taking their child to the hospital and hearing the diagnosis of “Pectus Carinatum” (pigeon chest), often feel confused:

• How many types of Pectus Carinatum are there?

• Is my child’s chest protrusion severe?

• Does it need treatment?

This article will help parents clearly understand the classification of pectus carinatum and how to initially assess severity at home.

1. What Are the Types of Pectus Carinatum?

Medically, pectus carinatum is mainly divided into three types. Knowing these types helps parents understand the doctor’s diagnosis and orthotic plan.

Type 1: Ship‑Keel Chest (Most Common)

• Feature: The middle and lower sternum protrudes forward, with the adjacent costal cartilages sinking inward, resembling an upside‑down boat.

• Proportion: Accounts for over 60% of all pectus carinatum cases [1].

• Development: Usually becomes noticeable after age 3–5 and worsens around puberty.

• Correction: Most mild‑to‑moderate ship‑keel chest can be corrected with a custom‑made orthotic brace.

Type 2: Pouter‑Pigeon Chest (Globular Chest)

• Feature: The manubrium (upper sternum) protrudes forward, while the middle body of the sternum is depressed, making the whole chest appear rounded, like a pigeon’s chest [2].

• Onset: Often appears in infancy or early childhood. Some children also have costal cartilage hyperplasia of the anterior chest wall.

• Treatment difficulty: Slightly more challenging than ship‑keel chest. Whether a brace is suitable requires a physician’s comprehensive assessment.

Type 3: Focal Pectus Carinatum

• Feature: Only one side of the chest wall or a single rib area shows localized protrusion; the rest of the chest is normal.

• Frequency: Relatively rare. It can be easily overlooked by parents and sometimes mistaken for a postural problem, delaying diagnosis [3].

• Correction: Whether intervention is needed depends on the extent of protrusion and its progression rate.