The interchondral ligaments connect the adjacent margins of the fifth to ninth costal cartilages where they articulate at the interchondral joints, forming the lower costal arch. These small fibrous bands stabilise the costal cartilage joints and maintain the integrity of the false rib cage below the true costal margin. The interchondral joints allow slight gliding during respiratory excursion.
Stabilise the interchondral joints between the 5th-9th costal cartilages, maintain the shape of the subcostal angle, and allow the controlled breathing motion of the lower rib cage.
The interchondral joints and ligaments are the site of pathology in slipping rib syndrome (clicking rib, Davies-Colley syndrome), where hypermobility of the interchondral articulation causes the lower rib edge to slip under the rib above, producing acute clicking lateral chest and upper abdominal pain. The condition is diagnosed by the hooking manoeuvre (hooking the finger under the lower rib margin and reproducing the click and pain). Resection of the involved rib segment and interchondral ligament provides definitive treatment.
Laxity of the interchondral ligament between the 8th-10th rib cartilages allows the lower rib to slip under the rib above during exertion, producing a painful clicking sensation in the lateral lower chest; the hooking manoeuvre reproduces the click and confirms the diagnosis, and resection of the involved cartilage segment with ligament reconstruction provides lasting relief.
