While the main causes of a protruding sternum are unknown, many doctors suspect a genetic link. More common in boys than girls, a protruding sternum may present fairly early in life, although 50% of cases are not caught until the patient hits puberty, often between 11 and 14 years of age. While many boys who suffer from a protruding sternum do not have fathers who had the same problem, there are enough family cases to warrant a belief that genes play a role, although the specific genetic make-up of the problem has yet to be discovered and is likely to be complicated.

Also called pigeon chest, a protruding sternum pushes forward, usually skewing to the left, giving the child’s chest the puffed-up appearance of a pigeon. Children with a sternal protrusion might have trouble playing and exercising. They might also experience some pain where the protrusion occurs. Protruding sternums have been associated with congenital heart defects as well as connective tissue problems, so it is important to have them checked by a doctor.

At the doctor’s office, patients will often be diagnosed with a protruding sternum after breathing for the doctor. A doctor might also order x-rays to measure the depth of the chest since a larger diameter is another indication of pigeon chest. Depending on the condition of the heart, a doctor might also request that the patient undergo an electrocardiogram test or an echocardiogram test.

Often a protruding sternum can be treated with a brace. The brace, worn at night, pushes against the sternum and cartilage, allowing it to move to a more normal position. In about 15% of cases, children with a protruding sternum also suffer from scoliosis, so a brace to correct the position of the spine may also be required.

In situations where protruding sternums are an indication of other physiological or medical problems, other treatments may be necessary. Such related problems include Marfan syndrome, which is a connective tissue disorder and osteogenesis imperfecta, more commonly known as brittle bone disease. Sufferers of Marfan syndrome may need to take medication or undergo surgery, depending on the organ damage they suffer through the disease. To protect their joints and delicate organs, they may need to wear braces and make lifestyle changes. Unfortunately, there currently is no cure for Marfan syndrome.

Patients suffering from brittle bone disease lack collagen that helps make bones and connective tissues strong. Like Marfan syndrome, there is no cure for this disease, but patients can lead productive lives with treatment, including medications, bracing, and hormone therapy.