A small bursa in the intercostal groove of each rib, between the neurovascular bundle and the inferior rib periosteum, reducing friction at the costal groove where the intercostal nerve and vessels run in a fibrous channel.
Intercostal periosteal bursitis contributes to intercostal neuralgia-pattern chest wall pain. It is compressed during rib fixation surgery and intercostal drain placement — adequate subperiosteal dissection below the rib protects the neurovascular bundle. Post-thoracotomy pain syndrome involves chronic irritation at this periosteal groove level.
Periosteal bursal inflammation at the costal groove producing intercostal neuralgia-pattern chest wall pain, a cause of post-thoracotomy pain syndrome managed with intercostal nerve block.
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