Rib Head

caput costae

The rib head is the posterior medial end of the rib that articulates with the thoracic vertebrae at the costovertebral joint. It has two articular facets separated by the crest of the rib head (interarticular crest): the superior facet articulates with the lower facet of the vertebra above, and the inferior facet articulates with the upper facet of the vertebra of the same number. The first, tenth, eleventh, and twelfth ribs have a single articular facet that articulates with only one vertebra.

Region: Chest

Clinical Relevance

Clinical Notes

The rib head and the costovertebral joint are relevant in posterior thoracic approaches (costotransversectomy, lateral extracavitary approach) where rib head removal provides access to the anterior thoracic vertebral body and disc without thoracotomy. Costovertebral joint pain from arthrosis or facet capsular irritation produces posterior chest wall pain reproduced by rotation and palpation at the rib head. Rib head dislocation is rare but occurs in Marfan syndrome and neuromuscular conditions.

Pathology

Common Injuries & Conditions

Costovertebral Joint Syndrome

Arthrosis or synovitis of the costovertebral joint produces a focal posterior thoracic pain at the rib head level reproduced by ipsilateral rotation and direct palpation, managed by intercostal nerve block or costovertebral joint injection under fluoroscopic guidance.