The superior costotransverse ligament runs from the crest of the neck of each rib to the transverse process of the vertebra above, reinforcing the superior aspect of the costotransverse joint.
Suspends the rib neck from the transverse process above, limits inferior rib movement, and provides the posterior reinforcement of the costotransverse joint. The intercostal nerve and vessels pass anterior to it.
The superior costotransverse ligament is the reference for intercostal nerve block at the posterior angle — the needle passes just inferior to the rib and beneath this ligament. Costotransverse joint arthropathy from degenerative disease produces thoracic paraspinal pain reproduced by trunk rotation, treated by costotransverse joint injection.
Degenerative changes in the costotransverse joint producing thoracic paraspinal pain, managed by fluoroscopic-guided joint injection.
The ligament serves as the posterior reference for intercostal nerve block — injection is placed just inferior to the rib beneath this ligament level.
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