The Costovertebral Joints

The articulations between ribs and the spine are called costovertebral joints. These joints are compound, so they have more than one pair of articulating surfaces. It means that any motion of the rib requires simultaneous action in two spacially separated joints: in the joint of the rib's head (articulatio capitis costae) and in the costotransverse joint (articulatio costotransversaria).

The importance of ligaments surrounding these joints is generally underestimated. However, the data available now suggest the leading role of these ligaments in maintaining the stability of the thoracic spine1,2, the involvement of these ligaments in developing scoliotic lesions3,4, and their potential importance in the surgical correction of scoliosis5.


  • 1 Panjabi M & Goel D. Physiologic strains in the lumbar spinal ligaments. Spine 1982, 7(3):192–203.
  • 2 Jiang, H. et al. Quantitative morphology of the lateral ligaments of the spine. Spine 1994, 19(23):2676–2682.
  • 3 Darwish H, et al. Radiate ligament shortening and idiopathic scoliosis. Saudi Med J 2012, 33(10):1093–9.
  • 4 Schultz A, et al. A study of geometrical relationships in scoliotic spines. J Biomech 1972, 5(4):409–420.
  • 5 Yao X. et al. A biomechanical study on the effects of rib head release on thoracic spinal motion. Eur Spine J 2012, 21(4)606–612 (2012).

  • Icon of crossfade image Costovertebral joints of the 1st and 8th rib
    The 1st and 8th costovertebral joints in situ The 1st and 8th costovertebral joints ex situ
    Costovertebral joints of the 1st and 8th rib. Anterolateral view.
    The joint of the rib's head is located between the head of the rib and the costal facet of one or two vertebral bodies. On the other hand, the costotransverse joint is between the articular surface of the costal tubercle and the costal facet of the transverse process.

    Articulatio Capitis Costae & Ligaments of the Heads of Ribs


    Icon of crossfade image The radiate ligament of the head of rib
    The radiate ligament of the head of rib Posterior wall of the rib cage
    1st, 10th, 11th, and 12th ribs articulate with the single vertebrae, while all other ribs articulate with two neighboring vertebrae. The count of involved vertebrae is reflected in the shape of the head of the rib. If the rib head has a crest, it articulates with two vertebrae; if there is no crest, it articulates with one.
    The main ligament stabilizing the joint is the radiate ligament of the head of rib (lig. capitis costae radiatum). Note that for ribs articulating with a single vertebra, the radiate ligament may be attached to the corresponding vertebral body and the vertebra above*.
  • *Standering S. Gray's Anatomy. 39ht ed. Elsevier Churchill Livingstone, 2005 p 955–961

  • Icon of crossfade image The bands of the ligamentum capitis costae radiatum
    The bands of the ligamentum capitis costae radiatum The intra-articular ligament of head of rib
    The joints of the rib's head. An inferior oblique view to the thorax with the rib cage cut made lateral to the angulus costae.
    The ligamentum capitis costae radiatum usually consists of 3 bands – the upper band, attaching to the upper vertebra; the middle band, connecting the head of a rib with the intervertebral disc; and the lower band, attaching to the lower vertebra*. Please note that the radiate ligament does not surround the head circumferentially. Dorsally the joint of the rib's head is sealed by the loose and irregular fibers of the articular capsule.
    Click an image to see the deeper layer – the lig. capitis costae intra-articulare, which extends from the crest of the head of rib to the intervertebral disc.
  • * Darwish H H, et al. Radiate ligament shortening and idiopathic scoliosis. Saudi Med J, 2012, 33(1):1093–9.

  • Articulatio Costotransversaria & The Lateral Costotransversal Ligament


    Icon of crossfade image The lateral costotransverse ligaments. The posterior aspect of thorax
    The lateral costotransverse ligaments. The posterior aspect of thorax The costotransverse joints. The posterior aspect of thorax
    Thorax & the costotransversal joints. Posterior aspect.
    The costotransverse joints (standard synovial joint with articular cartilages and articular gap) could be found in all ribs, except the floating one – the 11h and 12th. The lateral costotransverse ligament is the primary stabilizer of the costotransverse joint. The ligament is with the oblique course, running superiorly and laterally from the tip of the transverse process of the vertebra to the rough non-articular portion of the corresponding costal tubercle*.
  • * Ibrahim A F & Darwish H H. The costotransverse ligaments in human: A detailed anatomical study. Clin Anat 2005, 18(5):340–345.

  • Icon of crossfade image The capsule of the costotransverse joint with the lateral costotransverse ligament
    The capsule of the costotransverse joint with the lateral costotransverse ligament The articular facets of the costotransverse joint
    The left side costotransversal joints. Posterior aspect.
    Note the dense and compact lateral costotransverse ligaments, passing in oblique superolateral direction and the loose articular capsule, completely surrounding the costotransverse joint.


    Other Ligaments Stabilizing the Costovertebral Joint


    Some clarification is needed here. In this section, we are trying to present some evidence-based data that may not fully match the information provided in anatomy textbooks and atlases. The ligaments presented here are:

  • the lateral costotransverse (see above)
  • the costotransverse
  • the superior costotransverse
  • the inferior costotransverse, and
  • the posterior costotransverse ligaments;
  • The last two are not mentioned in the actual list of Anatomical Terminology but are described in the dedicated scientific literature and depicted in many anatomy atlases with original illustrations*.


  • * Bourgery J M, Jacob N H. Atlas of human anatomy and surgery. Vol.1, Plate 48. Taschen, 2015.
  •    Braus H. Anatomie des Menschen. Ein Lehrbuch für Studierende und Ärzte. Bewegungsapparat. Springer-Verlag Berlin Heidelberg, 1929
  •    Spalteholz W, Spanner R. Atlas of human anatomy. 16th ed. Scheltema & Holkema, 1967
  •    Pernkopf E. Atlas of topographical and applied human anatomy. Vol.2. Thorax, abdomen and extremities. W.B.Saunders Company, 1980

  • Icon of crossfade image The spine with the intervertebral discs. Multiple views
    The costotransverse and superior costotransverse ligaments
    The costotransverse ligaments
    Oblique posterior view of thorax, demonstrating the thick fibers of the costotransverse ligament joining the transverse process of the thoracic vertebrae with the neck of the corresponding rib. The last two ribs may not have such a ligament*.

  • *Ibrahim A & Darwish H. The costotransverse ligaments in human: a detailed anatomical study. Clin Anat 2005, 18(5):340–345.

  • Icon of crossfade image The layers of the superior costotransverse ligaments. The posterior aspect of thorax
    The layers of the superior costotransverse ligaments. The posterior aspect of thorax
    Icon of crossfade image The layers of the superior costotransverse ligaments. The anterolateral view to the posterior wall of the upper thorax
    The layers of the superior costotransverse ligaments. The anterolateral view to the posterior wall of the upper thorax
    The two images above demonstrate the superior costotransverse ligaments
    The superior costotransverse ligament connects the upper edge of the rib's neck with the lower surface of the transverse process of the vertebra above. The ligament consists of two layers – the fibers of the anterior layer are directed cranio-laterally, but those of the posterior layer – cranio-medially1–3. The lateral edge of the ligament fuses with the internal intercostal membrane. The superior costotransverse ligament is rudimentary or absent on the first rib2,4.
    Some authors suggest that the superior costotransverse ligament is the sole true ligament providing the lateral stability of the thoracic spine3.
  • 1 Arthrology. In: Williams P, et al., eds. Gray's Anatomy of the Human Body. 37th ed. Chuchill Livinstone, 1989:481–7
  • 2 Ibrahim A & Darwish H. The costotransverse ligaments in human: a detailed anatomical study. Clin Anat 2005, 18(5):340–345.
  • 3 Jiang, H. et al. Quantitative morphology of the lateral ligaments of the spine. Spine 1994, 19(23):2676–2682.
  • 4 Bannister L, et al., eds. Gray's anatomy. 38th ed. Churchill Livingstone, 1995, p.542–546

  • Icon of crossfade image The posterior costotransverse ligaments. Posterior and posterolateral aspect of the thorax
    The posterior costotransverse ligaments. Posterior and posterolateral aspect of the thorax
    The posterior and postero-lateral view to the thoracic spine with the proximal parts of the ribs.
    Both illustrations above demonstrate the posterior costotransverse ligaments connecting the non-articular part of the tubercle of the rib with the inferior articular process and the base of the transverse process of the vertebra above. The ligaments are usually identified in the lower part of the thorax – between the 5th and 10th rib. They are believed to stabilize the costotransverse joint against the strong pull of muscles during forced expiration and with increased intra-abdominal pressure1. The origin and insertion of this ligament differ from the superior costotransverse ligament. However, there are many misleading interpretations in anatomy atlases. In some sources, the posterior costotransverse ligaments are depicted but not labeled2,3; in others – this ligament is referred as the superior costotransverse4.
  • 1 Ibrahim A & Darwish H. The costotransverse ligaments in human: a detailed anatomical study. Clin Anat 2005, 18(5):340–345.
  • 2 Spalteholz W, Spanner R. Atlas of Human Anatomy. 16th ed. Scheltema & Holkema, 1967, p.77
  • 3 Putz R & Pabst R, eds. Sobbota Atlas of Human Anatomy. 14th ed. Vol.2, Urban & Fischer, 2006, Fig.787
  • 4 Pernkopf E. Atlas of Topographical and Applied Human Anatomy. 2nd ed. Vol.2, W.B.Saunders Company, 1980, Fig.115

  • Icon of crossfade image The costotransverse ligaments, including the inferior costotransverse ligament. Inferior oblique view to the posterior thoracic wall
    The costotransverse ligaments, including the inferior costotransverse ligament. Inferior oblique view to the posterior thoracic wall
    The thoracic spine with the proximal parts of the ribs. Inferior oblique view.
    The inferior costotransverse ligaments are the short bands connecting the inferior border of the neck of a rib to the anterior surface of the corresponding transverse process of the upper six vertebrae. These ligaments prevent the excessive mobility of the upper six ribs that might occur during deep inspiration1.
    The last rib is attached to the costal process of L1 and L2 by the lumbocostal ligament2.

  • 1 Ibrahim A & Darwish H. The costotransverse ligaments in human: a detailed anatomical study. Clin Anat 2005, 18(5):340–345.
  • 2 Rosse C & Gaddum-Rosse P. Hollinshead’s Textbook of Anatomy . Harper&Row, New York, 1974.

  • First published: 30/Jun/2021