Joints
Costovertebral joint (art. capitis costae)
The connection of the rib head to the spine. As a rule the head rests on two vertebrae at once: the inferior costal facet of the vertebra above and the superior facet of its own, with the disc between them. Ribs 1, 11 and 12 have a single facet only.
- Joint type
- Plane joint (art. plana) with two facets and an intra-articular ligament
- Latin name
- Articulatio capitis costae
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 | a few degrees per rib; at the top this mainly increases the anteroposterior diameter, lower down the transverse | firm springy (ligament) |
- Close-packed position
- Full inspiration
- Resting (loose-packed) position
- Quiet expiration
- Capsular pattern
- Pain on deep inspiration and on trunk rotation to the opposite side.
- Arthrokinematics
- The rib turns about an axis running through this joint and the costotransverse joint, roughly along the neck of the rib. High in the thorax that axis is nearly frontal, so the rib rises like a pump handle; lower down it is more oblique and the rib swings outward like a bucket handle.
- Stability
- The radiate ligament of the head externally and the intra-articular ligament dividing the head into two chambers and anchoring it to the disc.
- Palpation
- Not directly reachable; the joint lies too deep and too far anteriorly. What you can do is spring the rib a few centimetres lateral to the spinous process and compare the response with the level above and below.
- Clinical
- A restricted rib joint gives sharp, local pain between the shoulder blades that increases with deep breathing, coughing and turning: one of the few mechanical causes of thoracic pain that is clearly movement dependent. With pain that does not vary with movement, always think of heart, lungs and aorta first.
- Source
- Speciële anatomie van het houdings- en bewegingsapparaat (HU, 2013); BOKS anatomie Levensfasen (HU, 2024)