Diagnosis of Chest Wall Disorders

Your child’s pediatrician will start checking for this condition with a physical exam. They will also consider your child’s personal and family medical history. From there, their doctor may refer your child to a pediatric surgeon for further evaluation. Upon evaluation by the surgical team, your child may also be referred to other specialists including cardiology (heart), pulmonology (lung) and genetics when needed. Throughout this process, any of the specialists or their pediatricians may order one or more of the following tests to diagnose a chest wall disorder:

• Computerized tomography (CT) scan. This imaging test uses a specialized X-ray to create detailed pictures of the inside of your child’s chest, including the heart and lungs. A measurement called a “Haller Index” will be taken to determine the severity or degree of their condition.
• Echocardiogram (ECG). This test uses sound waves to create detailed images of your child’s chest, including the heart and lungs.
• Electrocardiogram (EKG). This test checks if your child’s heart rhythm and electrical signals are functioning normally.
• Exercise stress test. This test checks how your child’s heart and lungs work during exercise.
• Lung function test. This test checks to see if your child’s chest wall disorder affects how well their lungs work.
• Ultrasound. This imaging test uses sound waves to create detailed pictures of your child’s chest, including the heart and lungs.
• X-ray. This common imaging test uses radiation to create detailed pictures of the inside of your child’s chest, including the heart and lungs.

Treatments for Chest Wall Disorders

If your child has a chest wall disorder, their doctor may recommend one or more of the following treatment options:

• Bracing. Wearing temporary specialized braces may help alter your child’s chest appearance. Many people notice a difference with bracing in just a few months. This is the most common treatment for pectus carinatum.
• Physical therapy. Working with a specially trained physical therapist may help improve your child’s posture.
• Surgical repair. If your child is experiencing moderate to severe complications related to a chest wall disorder, their surgeon may recommend surgery. Depending on your child’s exact situation and needs, surgery could involve using temporary or permanent implants. Typically, a metal bar is placed and loft for a prolonged period of time. The surgeon will determine when the metal bar can be removed. Our surgeons offer two different approaches, including the Ravitch and the Nuss procedures. The most suitable approach for each child is determined on an individual basis.