An uneven rib cage means the sides of the rib cage are not symmetrical. There are several causes of uneven ribs, including scoliosis and Poland syndrome.
Alternatively, a person born with an uneven rib cage may not experience any associated pain or issues. An uneven rib cage can occur for a variety of reasons.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.
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Poland syndrome is a rare disorder that causes a person to be born with missing or underdeveloped muscles on one side of the body. According to the Genetic and Rare Diseases Center, it typically occurs on the right side of the body and is more common in males than females.
An infant born with Poland syndrome may have an underdeveloped or missing upper rib cage, causing the rib cage to be asymmetrical.
A person with Poland syndrome may also have the following symptoms:
- missing chest muscles
- unusually short or webbed fingers
- no armpit hair
- underdeveloped skin and fat tissue on the affected side
- underdeveloped nipple or breast tissue
- underdeveloped shoulder or arm bones
The severity of Poland syndrome can vary. Adolescents going through puberty may notice lopsided growth as the first sign of Poland syndrome.
Learn more about Poland syndrome here.
Treatment
People with mild Poland syndrome may not need any treatment. However,
Surgery to correct Poland syndrome involves reconstructing the missing chest muscles using existing muscles. The surgeon can use a rib graft to replace any missing ribs.
A person who requires surgery for Poland syndrome should wait until they have gone through puberty, if possible. Surgery before a person is fully developed can worsen the asymmetry of the chest.
Females with Poland syndrome should wait until the breasts are fully developed before having reconstructive surgery. This will ensure the reconstructed breast will be symmetrical to the other one.
Scoliosis is a condition that causes a person to have a curved spine. Scoliosis can affect either side of the body and give the appearance of an uneven rib cage.
Although anyone of any age can develop scoliosis, it is
Symptoms of scoliosis can include:
- tilted shoulders, with one more pronounced shoulder blade
- uneven waist
- ribs more prominent on one side than the other
- one hip higher than the other
- the appearance of leaning to one side
- spinal cord issues, causing numbness, weakness, and loss of coordination
Learn more about scoliosis here.
Treatment
The treatments for scoliosis can depend on:
- a person’s age
- stage of development
- the severity of the spinal curve
An infant with scoliosis typically needs to see their doctor regularly for X-rays. The doctor will observe the progress of scoliosis. Occasionally, a child’s scoliosis will improve or resolve by itself.
Other types of treatment include:
Bracing
If a young person’s scoliosis worsens, the doctor may recommend that they wear a corrective brace to prevent it from deteriorating further. When worn for 16 hours daily, a young person’s need for surgery can decrease.
A person can wear a corrective brace underneath clothes, which they can remove when showering.
Casting
Casting involves covering the individual’s chest in a plaster cast, which a healthcare professional replaces every few months.
Although casts can provide better curve management than braces, they can be uncomfortable and inconvenient.
Surgery
If a person’s spinal curve progresses, surgery can sometimes be necessary.
There are various surgeries available for the treatment of scoliosis, including:
- spinal fusion
- hemi-epiphysiodesis, or spinal fusion on the curve to allow the other side to grow normally
- hemivertebra resection, where a surgeon removes malformed vertebra to allow the spine to straighten
- growing rods, involving the attachment of metal rods to the spine to help it grow straight
Exercise and massage
Massage, pilates, and yoga may help with pain in a person with scoliosis.
However, these methods cannot reverse symptoms or prevent scoliosis from worsening.
Learn more about exercises to help with scoliosis here.
Cervical ribs are nonfunctioning ribs that grow near the neck.
Cervical ribs can occur on either side of the body but are more common on the left side.
On rare occasions, cervical ribs can compress surrounding blood vessels, causing numbness and tingling in the arm. Compression by the cervical rib can also cause the arm to become blue and swollen.
Treatment
Although a person with a cervical rib or ribs will typically experience no symptoms, surgery is available to remove the rib should complications occur.
Pectus excavatum, also known as funnel chest, is a condition in which a person’s breastbone sinks into their chest, leaving a large dent.
Doctors can find it challenging to diagnose pectus excavatum in infants as symptoms typically present in early childhood or adolescence.
People with pectus excavatum may experience the following symptoms:
- shortness of breath when exercising
- chest pain
- fatigue
- palpitations
- tachycardia, or a fast resting heart rate
- wheezing when exercising
- asthma, or lower respiratory tract infections
- fainting or dizziness
- feeling unable to exercise
- unpleasant sensation of fullness in the stomach
- anxiety and low body image
It can occur on both or either side of the chest.
Treatment
Anti-inflammatory medication, physical therapy, and acupuncture can help with pain management for a person with pectus excavatum.
Younger people can use vacuum bells to correct the dip in their chests. The device involves a person applying a suction cup to their chest for one hour per day.
If required, a person with pectus excavatum should preferably have corrective surgery during adolescence. However, the surgery is also available for adults and older adults.
Pectus carinatum, or keel chest, occurs when the rib cage pushes outwards. This condition can give the rib cage an uneven appearance.
Males are
Pectus carinatum can occur on both sides or either side of the chest, but it is more likely to appear on the right side.
People with pectus carinatum are unlikely to have other symptoms, although they can occasionally experience:
- tenderness of the chest
- shortness of breath
- abnormally fast breathing when exercising
- reduced endurance
- low body image
Learn more about pectus carinatum here.
Treatment
Corrective braces are a treatment option for pectus carinatum. However, a person must wear them
Since pectus carinatum often produces no adverse symptoms, surgery is usually cosmetic. Some people with pectus carinatum take up bodybuilding to minimize the protrusion of the breastbone.
A person with uneven ribs should visit a doctor if they are experiencing any pain or distress.
What causes an uneven rib cage?
Various conditions can cause an uneven rib cage, including Poland syndrome, scoliosis, pectus excavatum, or pectus carinatum.
Is it typical to have an extra rib on one side?
An extra rib, also known as a cervical rib, is a rare condition in which nonfunctioning ribs grow near the neck.
What is the best treatment for an uneven rib cage?
Treatment for an uneven rib cage depends on the cause. Some treatments may include reconstructive surgery, corrective bracing, casting, and physical therapy.
Several different conditions can cause uneven ribs. However, these conditions are usually manageable, and treatments and pain relief are available.
A person with uneven ribs will typically experience few or no adverse side effects. Should a person find that they are experiencing pain or distress, they should visit a doctor.