A small bursa between the first costal cartilage and the overlying subclavius muscle or costoclavicular ligament, reducing friction at this highly mobile junction. The first costal cartilage is unique in having a synchondrosis with the sternum rather than a true synovial joint.
First costal cartilage bursitis contributes to sternoclavicular and upper chest pain syndromes, particularly in patients who have had clavicle fractures or sternoclavicular joint problems. It is adjacent to the costoclavicular ligament attachment and can be identified on ultrasound as a small fluid collection. Injection at the first costal cartilage junction addresses this bursa and the adjacent costoclavicular ligament simultaneously.
Bursal inflammation at the first costal cartilage-manubrium junction producing upper sternal and costoclavicular pain, associated with sternoclavicular joint dysfunction and managed with localised injection.
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