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Author ORCID Identifier

Michael Maninang: https://orcid.org/0000-0002-8057-2302

Greg Almeter

Erik Pearson: https://orcid.org/0000-0002-3318-6505

Arvie Vitente: https://orcid.org/0000-0001-7177-7704

Abstract

Introduction: Scarce in‑vivo data describe how ribs move at the costotransverse joints during quiet breathing—knowledge critical to thoracic biomechanics and pain mechanisms. This pilot study uses four‑dimensional computed tomography (4D‑CT) to quantify, for the first time, the three‑dimensional magnitude and direction of rib motion at these joints throughout quiet respiration.

Methods: This retrospective, descriptive pilot study analyzed ten 4D‑CT scans obtained from patients undergoing thoracic imaging prior to radiation therapy. End‑expiration and end‑inspiration phases were aligned with a demons deformable‑registration algorithm. For each costotransverse joint, the three‑dimensional displacement vector, its absolute magnitude, and its components along the lateral–medial (L–M), anterior–posterior (A–P), and superior–inferior (S–I) axes were calculated.

Results: The mean translational magnitude between end‑expiration and end‑inspiration across all joints was 1.09 mm. Transverse‑plane motion exhibited considerable variability: 26 % of ribs moved antero‑laterally, 33 % postero‑laterally, 18 % antero‑medially, and 23 % postero‑medially. Vertically, 63 % translated inferiorly and 37 % superiorly.

Discussion/Conclusions: Quiet respiration produces small but measurable three‑planar translations at the costotransverse joints. Although displacements average just over 1 mm, their repetitive nature may impose cumulative mechanical stresses, potentially contributing to dysfunction or nociception. These baseline kinematic data offer a foundation for future studies investigating pathological rib mechanics and may inform clinical biomechanical assessment and intervention strategies.

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