Other Conditions of the Chest Wall

Chest wall anomalies include a broad spectrum of congenital anomalies. All of these deformities should be evaluated by a pediatric surgeon. Some may require immediate repair, while others may simply need to be observed over time. At Stanford Medicine Children’s Health, we are known for treating rare chest wall deformities. The following are some of the other conditions we treat:

Poland syndrome

This rare syndrome affects approximately 1 in 30,000 births. The following are some abnormalities it may include:

  • Absence of part or all of the muscles of the chest wall (pectoralis major, pectoralis minor, serratus anterior, rectus abdominus, latissimus dorsi).
  • Absence of breast tissue or nipple deformities.
  • Fusion (syndactyly) or shortening (brachydactyly) of the fingers and toes.
  • Absent axillary hair and limited fat layer under the skin.

Slipping rib syndrome

Slipping rib, also called “clicking rib,” “painful rib syndrome,” or “rib subluxation,” occurs when ribs in the lower chest slip or move. The 8th to 10th ribs are connected to your breastbone (sternum) and each other by cartilage and fibrous tissue (ligaments). When there is laxity in these connections, the ribs can move and push on the surrounding muscles and nerves, causing pain. This condition can be congenital or acquired (after traumatic injury or repetitive strain). Symptoms vary, but some patients report a sharp pain followed by a dull ache. This can be associated with a “clicking” or “popping” sensation. The pain can sometimes be triggered by certain movements, including coughing , lifting, bending, or twisting. It typically occurs on one side but can be seen on both sides.

Diagnosis of this condition is typically based off a patient’s description of symptoms, and a good physical examination by a provider who is familiar with the condition is essential. Imaging such as X-ray, MRI, or ultrasound may be helpful to rule out other conditions. Treatment varies from a more conservative approach to surgery. Some patients find pain relief with rest, anti-inflammatory medication, and/or physical therapy. For patients who require surgery, our expert surgeons make a small, targeted incision and remove the area causing pain. If needed, stabilization can be added to prevent mobilization.

Sternal cleft

This rare deformity can be associated with congenital cardiac defects and defects of the abdominal wall. A sternal cleft is a gap in the sternum (breastbone) that can span part or the entire length of the bone. The gap in the sternum may impair breathing. It can also result in decreased protection of the underlying organs, such as the heart and lungs.