This articulation is present in all but the eleventh and twelfth ribs. Ribs 1 to 10 have two joints in close proximity posteriorly; the costovertebral joints and the costotranseverse joints. This arrangement restrains the motion of the ribs allowing them to work in a parallel fashion during breathing. If a typical rib had only one joint posteriorly the resultant swivel action would allow a rib to be non-parallel with respect to the neighboring ribs making for a very inefficient respiratory mechanism. The ventral rami innervate the costotransverse joints. Therefore, therapeutic medial branch blocks are ineffectual.

The ligaments of the joint are:

• Articular capsule
• Posterior costotransverse
• Anterior costotransverse
• Ligament of the neck of the rib
• Ligament of the tubercle of the rib

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