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.
