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Costotransverse ligament

The costotransverse ligament is a short, strong fibrous band that reinforces the articulation between the rib and the transverse process of the corresponding thoracic vertebra. It extends from the posterior surface of the rib neck to the anterior surface of the transverse process, stabilizing the costotransverse joint.

This ligament is present in all typical ribs (2nd–10th), but is strongest in the upper thoracic levels where rib motion is more restricted. Along with the lateral and superior costotransverse ligaments, it forms the ligamentous complex of the costotransverse articulation.

Functionally, the costotransverse ligament limits excessive gliding and rotation of the rib, maintaining alignment of the rib with the vertebra during respiration. It also plays a structural role in stabilizing the thoracic cage and contributes to the overall mechanics of breathing, posture, and thoracic rigidity.

Clinically, the costotransverse ligament can be affected in trauma, arthritic changes, or inflammatory conditions, and may contribute to thoracic pain syndromes. Its small size makes it difficult to visualize directly, but it is an important anatomical landmark in radiology.

Synonyms

  • Ligamentum costotransversarium

  • Rib–transverse ligament

  • Posterior thoracic ligament (colloquial)

Function

  • Stabilizes the costotransverse joint by limiting excessive rib motion

  • Supports the articulation between the rib neck and transverse process

  • Contributes to thoracic spine and rib cage rigidity during respiration

  • Works with lateral and superior costotransverse ligaments to form a supporting ligamentous complex

MRI Appearance

T1-weighted images:

  • Appears as a low-signal intensity band between rib neck and transverse process

  • Surrounded by intermediate signal fat planes, aiding identification

T2-weighted images:

  • Normal ligament remains low signal

  • Increased signal suggests edema, sprain, or inflammation

STIR:

  • Fat suppression enhances contrast, making ligament low signal against hyperintense fat

  • Pathologic edema or inflammatory changes appear bright hyperintense

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Normal ligament does not enhance

  • Pathologic enhancement may be seen in inflammatory arthritis, infection, or neoplastic infiltration

MRI 3D Non-Contrast Imaging:

  • High-resolution 3D datasets show ligament orientation and relationship with the costotransverse joint

  • Useful for assessing joint degeneration or congenital anomalies

CT Appearance

Non-contrast CT:

  • Costotransverse ligament is not directly visualized due to its soft tissue density

  • Bony landmarks (rib neck, transverse process) define its location

  • Useful for detecting calcification, ossification, or adjacent degenerative changes

CT Post-Contrast:

  • Enhances surrounding soft tissue planes, improving detection of inflammatory or neoplastic changes near the ligament

  • 3D reconstructions highlight the costotransverse joint complex and spatial relationships

MRI images

Costotransverse ligament mri axial image -img-00000-00000

MRI images

Costotransverse ligament mri coronal image -img-00000-00000