carinatum

Carinatum is a Latin-derived term meaning keel-shaped, and it is used in anatomy and biology to describe a keel-like ridge. In clinical contexts, the most common usage is pectus carinatum, a chest wall deformity in which the sternum and adjacent costal cartilages protrude outward, giving the chest a convex, pigeon-like profile.

Pectus carinatum can be isolated or associated with underlying connective tissue disorders and, less commonly, other skeletal abnormalities. It often becomes noticeable during adolescence and tends to be more frequent in males. The exact cause is not fully understood, but genetic factors are suspected, and it may occur alongside scoliosis or other chest wall anomalies in some patients.

Diagnosis is usually clinical, based on visible protrusion of the sternum. Imaging, such as chest radiography or computed tomography, can help assess severity and rule out other chest wall lesions. While there is no single universal severity index for carinatum, imaging complements physical examination in planning treatment.

Treatment options depend on severity, age, and patient preference. Mild cases or those without symptoms may be observed. In skeletally immature individuals, external bracing or compression devices can gradually remodel the chest wall over months. Surgical correction is considered for severe deformities or persistent cosmetic concerns. Historical approaches include the Ravitch procedure, which involves resection of affected costal cartilages and sternal osteotomy. Modern techniques emphasize less invasive cartilage modification and sternal repositioning when appropriate, often supplemented by postoperative bracing.

Prognosis is generally favorable with treatment, though recurrence can occur after surgery. Management typically involves a multidisciplinary team including pediatric surgery or thoracic surgery, and ongoing follow-up is common.

See also: pectus carinatum, pectus excavatum.