Pectus Arcuatum: A Pectus Unlike Any Other

Infographic · Dec 2023 · 1 min read

In brief

Pectus arcuatum is a distinct chest wall deformity caused by premature sternal suture fusion, not abnormal cartilage growth like pectus carinatum. This multicenter study of 34 patients found 35% had associated malformations, orthopedic bracing was ineffective, and surgical correction via sternotomy is the definitive treatment.

Pectus arcuatum is distinct from pectus carinatum—caused by premature sternal suture fusion, not costal cartilage overgrowth.
35% of patients have associated malformations (Noonan syndrome 33%, scoliosis 25%, cardiac defects 16%); screen systematically.
Orthopedic bracing is ineffective for pectus arcuatum; surgical correction requires sternotomy with partial chondrocostal resection.
Diagnosis confirmed by lateral chest X-ray or CT showing sternal fusion; complete fusion seen in 75% of imaged cases.
Surgical correction best performed at end of growth; 64% of operated patients achieved complete correction in this series.

Written by the GCMD Library team from the infographic.

The infographic uses a teal and yellow color scheme with icon-based visual elements. The top section features study design icons (calendar, building, location pin) against a dark teal banner. The middle section displays patient statistics with a medical illustration of healthcare providers and a ribcage icon. A yellow conclusion box appears on the right side. Hospital and journal logos are positioned at the bottom.

New infographic from JPS by Dr. Cecilia Gigena

"Pectus Arcuatum: A Pectus Unlike Any Other"

Authors: Sarah Abdellaoui, Aur elien Scalabre, Christian Piolat, Frederic Lavrand, Amane-Allah Lachkar, Anne Lehn, Clemence Klipfel, Brice Henry, Valentin Soldea, Frederic Hameury, François Becmeur

Full article: https://www.jpedsurg.org/article/S0022-3468(23)00226-9/fulltext#%20

Background

Pectus arcuatum is often mistaken for a type of pectus carinatum. However, pectus arcuatum is a unique clinical form of pectus caused by premature obliteration of the sternal sutures (manubrial sternum, four sternebrae and xiphoïd process), whereas pectus carinatum is due to abnormal growth of the costal cartilage. In order to better describe pectus arcuatum, we analysed the files of patients with pectus arcuatum followed in our centers.

Methods

Multicenter retrospective study of young patients’ files diagnosed with pectus arcuatum.

Results

The clinical diagnosis of pectus arcuatum was made in 34 patients with a mean age at diagnosis of 10.3 years (4–23 years).

A chest profile X-ray or a CT scan was performed in 16 patients (47%) and confirmed the diagnosis of PA by the presence of a sternal fusion. It was complete in 12 patients.

A malformation was associated in 35% of cases (Noonan syndrome 33%, scoliosis 25% or cardiopathy 16%). 11 patients (32%) had a family history of skeletal malformation.

Orthopedic treatment was initiated in 3 patients without any success. 11 patients underwent surgical correction, which was completed in 7 of them.

Conclusion

The diagnosis of pectus arcuatum is based on clinical experience and if necessary, on a profile chest X-ray showing the fusion of the sternal pieces. It implies the search for any associated malformations (musculoskeletal, cardiac, syndromic). Bracing treatment is useless for pectus arcuatum. Corrective surgery, based on a sternotomy associated with a partial chondro-costal resection, can be performed at the end of growth.

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