The intra-articular ligament of the head of the rib is a short, flat band running from the crest on the head of a typical rib to the adjacent intervertebral disc. It splits the joint of the head of the rib into two separate synovial compartments. It is present at ribs 2-9 and absent at ribs 1, 10, 11 and 12, whose heads articulate with a single vertebra.
| Origin | Crest of the head of the rib, between its two articular facets |
|---|---|
| Insertion | Intervertebral disc between the two vertebrae that the rib head articulates with |
Binds the rib head to the intervertebral disc and divides the costovertebral joint into upper and lower synovial cavities.
The ligament is deep within the costovertebral joint and is rarely injured in isolation, but it is disrupted along with the radiate ligament in rib head dislocations and thoracic fracture-dislocations. Degeneration of the costovertebral joints can be a source of posterior thoracic pain referred around the chest wall. Surgeons divide the ligament when removing the rib head during costotransversectomy to reach the thoracic disc or vertebral body.
Strain of the rib head ligaments from twisting, heavy lifting or violent coughing, producing sharp paraspinal thoracic pain worsened by deep breathing and trunk rotation.
Rare high-energy injury in which the intra-articular and radiate ligaments tear and the rib head displaces from the vertebral bodies, often with associated thoracic spine fractures.
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