The costotransverse ligaments connect the rib necks to the transverse processes of the corresponding vertebrae, stabilising the costovertebral articulations and guiding the pump-handle and bucket-handle rib movements during breathing. There are three components: the lateral costotransverse ligament, the superior costotransverse ligament, and the costotransverse ligament proper. Their disruption in thoracic fracture-dislocations contributes to rib instability and paradoxical chest wall movement.
| Origin | Costotransverse joint capsule and adjacent rib neck |
|---|---|
| Insertion | Transverse process of the corresponding thoracic vertebra |
| Actions | Stabilise the costotransverse joint during respiratory and spinal movements, guide rib movement during breathing |
|---|
Costotransverse joint dysfunction is a recognised cause of thoracic back pain that is reproduced by specific provocative testing of the joint and responds to joint injection or manual therapy. The costovertebral joints and costotransverse joints together are assessed in patients with unexplained thoracic pain after exclusion of disc, facet, and visceral pathology.
Restricted and painful costotransverse joint movement producing thoracic back pain reproduced by rib springing tests and managed with joint injection or spinal manipulation.
