DS rib cage sunken on one side

[SnarkyBag]

DS has had a growth spurt recently and as a result he lost a lot of puppy fat. Tonight he had no shirt on and his left side lower rib cage is notably more indented than the right. I’ve never noticed this before and he’s gone through periods of being slim getting a bit chunky before slimming out with his next growth spurt.

I’m concerned it could be a sign of something more serious like scoliosis anyone had similar with their young teen?

Yeah, it could well be scoliosis or what we used to call pigeon chest - proper name Pectus carinatum.

It's not necessarily anything to worry about, but obviously you should get it checked out. Early teens is prime time for noticing it, DS has pigeon chest and we discovered it under exactly the same circumstances.

He's been to the chest wall clinic for X-rays but nothing to worry about. It is very noticeable on him but he is VERY skinny. When he starts to lay down some muscle it shouldn't look as bad. But the main thing is it's not serious. Do get it checked though because there can be complications and they can treat it if bad enough.

Thank you @MilkshakesBringAllTheCoosToTheYard I’ve just asked DS 1 to look and at first he said loads of lads chest look like that (he’s a real gym buff) that but then he caught a side view and was like “woah” not so normal. Bit worrying to be honest I’ve just got him to stand straight and looks at his shoulders and spine and the left shoulder sits slightly lower but not obviously crooked.

He also has over pronated feet and hyper mobility so his posture hasn’t always been great although much better since he’s had foot orthotics and physio. Will call the doctors on Monday

Carinatum is where the chest sticks out . Excavatum is if it's indented . Our son had the former and was treated at the London Orthotic's Clinic in Kingston .

Yes, it sounds like scoliosis, especially if he’s just had a growth spurt. Rib cage rotation is what I noticed first in DD, it wasn’t until much later on that you could see a curve in her spine or any shoulder asymmetry. If you get him to do the forward bend test you will be able to see it better - one side will be raised.

Definitely ask your GP for a referral to an orthopaedic spine consultant so that they can evaluate things. The sooner it’s caught the easier it is to treat conservatively. DD was diagnosed at 16, now 18 and had very successful surgery to straighten her spine earlier this year.

Thank you for the replies it’s worrying but I will phone the doctor today to get it checked out

Try not to worry - I think the overall message is it could be 'a thing' but either not a thing to worry about or a thing that is totally treatable.

What I would say though is get referred to a specialist. We were referred to our general hospital who really didn't understand what they were looking at. You want someone who sees this every day. And if there's anything there, you'll be onward referred to the specialist anyway so may as well cut out the middle man!

Hi, a friend of ds has pectus excavatum. It sometimes goes hand in hand with scoliosis but not always.

Unfortunately the NHS in England decided in 2019 to de-fund the procedure required to correct this. They said there was no proof of effectivness which is absolute rubbish having spoken to the parents of other young people affected. The surgery required is non evasive and is still available in Scotland and Wales, & indeed most of the rest of the worldm just not England.

The good news is that apparently in most cases the condition is just cosmetic. Unfortunately in 10% of cases the heart and lungs are affected. A scan can determine whether or not this is the case. Ds's friend is one of the 10% and has been told that unless he can pay £18,000 (an impossible amount of money) he just has to put up with the symptoms.

This is an option for some young people. The cost is approx £2,000. Unfortunately ds's friend had a consutlation there and they advised that he needed the operation, not the cheaper non surgical option.

Try not to worry, @SnarkyBag Pp is correct. It sounds like it is pectus excavatum. He will need referral to a specialist clinic. They will want to check his overall health especially heart and lungs. But it is all treatable Your son may decide he is happy to live with the look - many people do. A specialist clinic will be able to advise on his options. It is associated with scoliosis and kyphosis but again both are treatable and can be mild so not need treatment in boys.

CaptainCavemum - Do you have any information on how it is treatable on the NHS as ds's friend has drawn a complete blank.

I've been in conversation with a lovely lady who has a son called Harry. Harry is severly affected (but OP please be reassured again that this is only the 10%). He too, has been refused treatment on the NHS but they have managed to fundraise and an anonymous donor provided the balance of the £18k needed.

@Comefromaway surgery isn’t routinely commissioned (paid for by the nhs). But in most cases this isn’t a problem as there are good non-invasive treatments. If surgery is needed because the heart or lungs are affected, surgery should be available on the nhs in specialist units eg Royal Brompton, Great Ormond Street, Liverpool Children's, etc (you can google to find one near you and then ask your GP to refer there).

He turned 18 about 6 months before he was diagnosed (he never thought to question his chest before ansd he initially went to the GP for potential scoliosis/breathing issues/heart palpitations so doesn't come under children's services.

Our NHS Trust wrote him a letter saying that they will not fund the procedure.

The lady I spoke to her young lad is affected even worse and the NHS too absolutely refuse to fund it.

www.essexlive.news/news/health/teen-caved-chest-could-crush-7575919

This is her and her son. The article doesn't say everything but she has tried everything.

An individual funding request will only be granted if the condition is life threatening. It won't be granted if it is causing significant physical impairment/function.

It's ridiculous. Ds's friend is currently working in a job where he has to maintain a certain level of physical fitness in order to retain his registration. It is already affecting his ability to both carry out his job and his day to day life. Surely the cost of surgery would be offset by the potential cost to the state of him not being able to work?

Have an appointment booked with the GP. Bit for two weeks so we’ll just have to wait and see.

Get him checked my sons was the same and he has scoliosis x