Costal margin

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The costal margin, also known as the costal arch,[1] is the lower edge of the chest (thorax) formed by the bottom edge of the rib cage.

Costal margin
Anterior surface of sternum and costal cartilages. (The costal margin forms a large upside-down V on the inferior border.)
LatinArcus costalis
Anatomical terminology


The costal margin is the medial margin formed by the cartilages of the seventh to tenth ribs. It attaches to the manubrium and xiphoid process of the sternum.[2]

The thoracic diaphragm attaches to the costal margin.[3]

The costal angle is the angle between the left and right costal margins where they join the sternum.[2]


The costal margins somewhat protect the higher abdominal organs, such as the liver.[4][5]

Clinical significanceEdit

The costal margin may be used for tissue harvesting of cartilage for use elsewhere in the body, such as to treat microtia.[4]

Different abdominal organs may be palpated just below the costal margin, such as the liver on the right side of the body.[5]

Pain across the costal margin is most commonly caused by costochondritis.[6]

The costal paradox, also known as Hoover's sign and the costal margin paradox, is a sign where the costal angle decreases upon inspiration rather than increasing, indicating chronic obstructive pulmonary disease.[2]


  1. ^ Talucci, R. C.; Webb, W. R. (March 1983). "Costal chondritis: the costal arch". The Annals of Thoracic Surgery. 35 (3): 318–321. doi:10.1016/s0003-4975(10)61566-4. ISSN 0003-4975. PMID 6830368.
  2. ^ a b c McGee, Steven (2018-01-01), McGee, Steven (ed.), "Chapter 33 - Chronic Obstructive Lung Disease", Evidence-Based Physical Diagnosis (Fourth Edition), Philadelphia: Elsevier, pp. 285–290.e2, ISBN 978-0-323-39276-1, retrieved 2021-01-04
  3. ^ Mack, Savannah M.; Wu, Ching-Wen; Zhang, Chuanzhen; Richard Harding; Pinkerton, Kent E. (2020-01-01), "Lung Anatomy and Aging☆", Reference Module in Biomedical Sciences, Elsevier, ISBN 978-0-12-801238-3, retrieved 2021-01-04
  4. ^ a b Szpalski, C.; McRae, M.; Rogers, G. F.; Bumgardner, J. D.; Warren, S. M. (2011-01-01), Ducheyne, Paul (ed.), "6.621 - Biomaterials and Their Application in Craniomaxillofacial Surgery", Comprehensive Biomaterials, Oxford: Elsevier, pp. 325–341, ISBN 978-0-08-055294-1, retrieved 2021-01-04
  5. ^ a b McGee, Steven (2018-01-01), McGee, Steven (ed.), "Chapter 51 - Palpation and Percussion of the Abdomen", Evidence-Based Physical Diagnosis (Fourth Edition), Philadelphia: Elsevier, pp. 433–444.e4, ISBN 978-0-323-39276-1, retrieved 2021-01-04
  6. ^ Suresh, Santhanam; McClain, Brenda C.; Tarbell, Sally (2008-01-01), Benzon, Honorio T.; Rathmell, James P.; Wu, Christopher L.; Turk, Dennis C. (eds.), "Chapter 16 - Chronic Pain Management in Children", Raj's Practical Management of Pain (Fourth Edition), Philadelphia: Mosby, pp. 343–365, ISBN 978-0-323-04184-3, retrieved 2021-01-04

External linksEdit