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Differential Diagnosis

  • Pectus carinatum
  • Pectus excavatum
  • Poland syndrome
  • Pentalogy of Cantrell
45-Year-Old with Chest Deformity issue identified


The x-ray shows an angulated appearance of the lower sternum. This patient was diagnosed with pectus carinatum, otherwise known as a pigeon chest, in which the sternum protrudes anteriorly.

Learnings/What to Look for

  • Shortness of breath and exercise intolerance are common symptoms
  • Radiographic features include two patterns of sternal protrusion: chondrogladiolar (protrusion of the middle and lower sternum) and chondromanubrial (protrusion of the manubrium and upper sternum)
    • Pectus carinatum can be associated with scoliosis, Marfan syndrome, and other disorders
    • Familial occurrence is reported in approximately 25% of cases and usual diagnosis occurs during childhood or adolescence

Pearls for Urgent Care Management

  • Nonsurgical external bracing may be effective, especially in adolescents
  • Referral for surgical consideration may be necessary

Acknowledgement: Image and case presented by Experity Teleradiology (

A 45-Year-Old with Chest Deformity