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Costal cartilages

The costal cartilages are bars of hyaline cartilage that connect the anterior ends of the ribs to the sternum and contribute to the elasticity and flexibility of the thoracic wall. The first seven pairs of ribs (true ribs) articulate directly with the sternum via their costal cartilages, while ribs 8–10 (false ribs) join the costal cartilage above, and ribs 11–12 (floating ribs) have no anterior cartilage attachment. Costal cartilages allow the rib cage to expand and contract during respiration and gradually undergo calcification with age, especially in adults over 30 years.

Synonyms

  • Rib cartilage

  • Thoracic wall cartilage

  • Chondral portion of ribs

Function

  • Provides flexibility and elasticity to the rib cage

  • Connects ribs to the sternum and stabilizes the thoracic wall

  • Assists in respiratory movements by allowing expansion of the chest cavity

  • Protects underlying thoracic organs (lungs, heart) by absorbing mechanical stress

MRI Appearance

T1-weighted images:

  • Costal cartilage appears as low to intermediate signal intensity

  • Surrounded by hyperintense fat and intermediate signal muscle, which outline its margins

  • Degeneration or inflammation may alter signal characteristics

T2-weighted images:

  • Appears  low to intermediate signal intensity

  • Calcified regions appear as signal voids (dark areas)

  • Useful for detecting inflammation, edema, or chondral injury

STIR (Short Tau Inversion Recovery):

  • Fat suppression improves visualization of cartilage

  • Abnormalities such as costochondritis, fractures, or edema appear bright hyperintense

  • Normal cartilage shows low-to-intermediate signal

T1 Post-Contrast (Gadolinium-enhanced):

  • Normal cartilage shows minimal or no enhancement

  • Pathological processes (e.g., inflammation, neoplasm, infection) may show heterogeneous enhancement

CT Appearance

Non-contrast CT:

  • Costal cartilages are visualized as soft tissue density structures anterior to the ribs

  • With age, calcification produces patchy or linear hyperdensities

  • Provides excellent visualization of calcifications, fractures, or deformities

Contrast-enhanced CT (CECT):

  • Contrast does not significantly enhance normal costal cartilage

  • Helpful for evaluating inflammatory conditions, tumors, or trauma affecting the chest wall

MRI image

Costal cartilage anatomy MRI CORONAL image -img-00000-00000

CT images

Costal cartilage anatomy CT axial image -img-00000-00000

CT images

Costal cartilage anatomy CT CORONAL image -img-00000-00000