Costovertebral Joints

Costovertebral joints are synovial joints between the heads of the ribs and the bodies of the thoracic vertebrae. These joints enable articulation of the ribs with the spine and play a key role in respiratory mechanics by allowing slight gliding movements during breathing. They are found from the 2nd to the 9th ribs and are supported by strong ligaments.

Location

These joints are located posteriorly within the thoracic cage, between the rib heads and the lateral aspects of the vertebral bodies and intervertebral discs of the thoracic vertebrae (T1–T12).

Joint Formation

Each costovertebral joint typically involves:

• The head of a rib
• The inferior costal facet of the vertebra above
• The superior costal facet of the corresponding vertebra
• The intervertebral disc between the two vertebrae

For example, the head of rib 5 articulates with the inferior facet of T4, the superior facet of T5, and the intervertebral disc between T4 and T5.

Exceptions

• Ribs 1, 10, 11, and 12: Each articulates with a single vertebral body (no demifacets)
• Ribs 11 and 12: No articulation with transverse processes; only form costovertebral joints

Joint Type

Synovial plane joints – allow small gliding movements, important for the elevation and depression of ribs during respiration.

Ligaments

Costovertebral joints are stabilized by several ligaments:

• Radiate ligament: Connects the rib head to the vertebral bodies and intervertebral disc
• Intra-articular ligament: Divides the joint into two synovial cavities; attaches the rib head to the intervertebral disc (only in ribs 2–9)
• Capsular ligament: Surrounds the joint and provides additional support

Movements

• Slight gliding motions of the rib head during respiration
• Movement contributes to the bucket-handle mechanism of breathing (especially in lower ribs)

Function

• Provide articulation between the ribs and the vertebral column
• Allow rib motion necessary for respiration
• Maintain structural integrity and flexibility of the thoracic cage

Innervation

• Intercostal nerves (posterior rami)

Clinical Relevance

• Costovertebral joint dysfunction: Can cause localized thoracic pain, often aggravated by deep breathing or rotation
• Arthritis: Degeneration of the costovertebral joints may be seen in aging or inflammatory conditions
• Rib fractures: May disrupt the joint or its ligaments, impairing movement and causing sharp pain
• Surgical significance: Important to consider in thoracic and spinal surgeries, especially during posterior thoracotomy or vertebral instrumentation