Joints
Costotransverse joint (art. costotransversaria)
The connection between the rib tubercle and the transverse process of the vertebra of the same number. Together with the rib head joint it fixes the axis of rotation of the rib: two joints that between them leave exactly one direction of movement. Ribs 11 and 12 lack this joint and therefore move much more freely.
- Joint type
- Plane joint (art. plana); slightly convex in the upper thorax, flatter lower down
- Latin name
- Articulatio costotransversaria
Movements, axes and normal values
| Movement | Plane | Axis | Normal range | End feel |
|---|---|---|---|---|
| Rib elevation on inspiration | combined | oblique, along the axis of the rib neck | mainly rotation of the rib in the upper thorax, more of a cranial and lateral glide lower down | firm springy (ligament) |
- Close-packed position
- Full inspiration
- Resting (loose-packed) position
- Quiet expiration
- Capsular pattern
- Pain on deep inspiration and on lateral flexion to the opposite side.
- Arthrokinematics
- In the upper six levels the facet on the transverse process is concave and that on the rib convex, so the rib mainly rotates in it. From about rib seven both surfaces flatten and the rib glides upward and sideways. That difference explains why the pump-handle motion dominates high in the thorax and the bucket-handle motion low down.
- Stability
- The costotransverse ligaments: the costotransverse ligament proper, the superior one to the vertebra above and the lateral one to the tip of the transverse process.
- Palpation
- The most accessible of the rib joints: about three to four centimetres lateral to the spinous process, deep to the erector spinae. Springing anteroposteriorly at that point and comparing with the neighbouring level is the usual examination.
- Clinical
- With reduced chest excursion, as in COPD or after a long admission, these joints stiffen first, and that costs breathing volume before the lungs themselves are the limit. Mobilising them therefore belongs to pulmonary rehabilitation and not only to the treatment of back pain.
- Source
- Speciële anatomie van het houdings- en bewegingsapparaat (HU, 2013); BOKS anatomie MSA (HU, 2024)