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Deformity in Ankylosing Spondylitis
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
The patient should be asked to stand upright against a flat surface. The cervico-thoracic or upper thoracic kyphosis deformity associated with severe AS can lead to a chin on chest deformity, with a loss of horizontal gaze. Costovertebral joint involvement can lead to reduced chest wall expansion, and patients should be inspected for signs of breathlessness after gait examination.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
Joints found only in the thoracic region of the vertebral column are the costovertebral and costotransverse joints. These are the articulations between the thoracic vertebrae and ribs. The costovertebral joint is between the vertebral body (see vertebral structure) and the head of the rib. The costotransverse joint is between the transverse process of the vertebra and the articular facet of the rib tubercle. Most ribs articulate with two adjacent vertebral bodies and the costotransverse joint is formed with the transverse process of the inferior vertebrae.
Inflammatory rheumatic disorders
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Synovitis of the sacroiliac and vertebral facet joints causes destruction of articular cartilage and periar-ticular bone. The costovertebral joints also are frequently involved, leading to diminished respiratory excursion. When peripheral joints are affected, the same changes occur.
Intra and inter observer agreement in the mobility assessment of the upper thoracic costovertebral joints
Published in Physiotherapy Theory and Practice, 2023
Michael Cibulka, Justin Buck, Bria Busta, Erika Neil, Drake Smith, Reece Triller
Each costo-vertebral articulation in the thoracic spine consists of two left and right synovial joints (i.e. costovertebral and costotransverse) that connect the head of each rib to the thoracic transverse process and the vertebral body. Although the costovertebral and costotransverse joints are two separate joints they move together, movement of one joint cannot occur without movement at the other joint (Fruth, 2006). The costovertebral joints are innervated with nociceptors capable of sending pain through the lateral branch of the thoracic dorsal rami (Bogduk, 2002; Erwin, Jackson, and Homonko, 2000). Pain originating from these joints is well-localized, unilateral, and level specific creating pain just slightly lateral to the spinous process (Saker et al., 2016; Young, Gill, Wainner, and Flynn, 2008). Assessing the mobility of the costovertebral joints is important when differentiating the source of a person’s upper thoracic pain, lower cervical pain, thoracic outlet syndrome, and planning a physical therapy intervention (Fruth, 2006; Hooper et al., 2010; Kuwayama, Lund, Brantigan, and Glebova, 2017).
Influence of morphology and material properties on the range of motion of the costovertebral joint – a probabilistic finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Benedikt Schlager, Frank Niemeyer, Christian Liebsch, Fabio Galbusera, Julius Boettinger, Daniel Vogele, Hans-Joachim Wilke
The rib cage plays an important role in human trunk biomechanics, such as respiration (Agostoni et al. 1967; Wilson et al. 1987; Cappello and De Troyer 2004), protection and support of the viscera, as well as in the stabilization of the spine (Andriacchi et al. 1974; Oda et al. 1996; Brasiliense et al. 2011; Liebsch et al. 2016, 2017). The main mechanical links between the rib cage and the thoracic spine are the costovertebral joints (CVJ), which provide an articular connection between a rib and its adjacent vertebrae. In consideration of the functions of the ribcage, the costovertebral joint provides a stable link between a rib and the adjacent vertebra with the ability to transmit high loads to the spine, while at the same time offering enough flexibility for respiration.