Figure 21(a) shows the surrounding structures when the transducer is placed immediately caudal to the
costotransverse joint. Because the probe has a width and all the three-dimensional information scanned beneath the probe will be processed by the computer to be presented as a two-dimensional image on the monitor, the tip of the transverse process, which is not in the same plane of the needle and injection, will often appear as if it is in the same plane, providing additional information to confirm the costotransverse ligament position through visualization of its superomedial origin on the transverse process.
(12-14) Thoracic facet (15) and costotransverse joint pain patterns are well demonstrated as contributing to TSP (16).
Thoracic costotransverse joint pain patterns: a study in normal volunteers.
(24) Crepitus during chest wall palpation is another common physical exam finding, (24) as well as costovertebral and costotransverse joint restrictions upon joint play assessment (25) and motion palpation (26,27) similar to that discovered in the current case.
(4) While the exact mechanism of this condition has yet to be defined, inflammation in this area is generally caused by an increase in pulling at this joint, likely from adjoining muscles to the rib or dysfunction at the costotransverse joints. (5)
Prone posterior-anterior compression over the
costotransverse joints was unremarkable.
Inflammation mainly affects the spinal joints, which may lead to imbalance in the
costotransverse joints with pain and greatly limited thoracic mobility as a result.
Associated bony lesions included multiple rib fractures, spinous processes fractures, fractures of the
costotransverse joints, and bilateral fractures of the wrists in one case.
4) and facet joints of the thoracic spine, and costovertebral and
costotransverse joints' that causes an exaggerated kyphosis with decreased chest expansion during inhalation and increased susceptibility to respiratory tract infections.
Due to the contour of the thoracic laminae and general orientation of the articular processes the zygapophysial joints appear to lie flat, close to the spinous processes with the prominent
costotransverse joints lying more laterally (Figure 1).
Two joints potentially implicated in the development of stress fractures are the costovertebral and
costotransverse joints (11).