The costovertebral articulations consist of two gliding type synovial joints, the costocentral and the costotransverse. When subjected to severe trauma, these joints may be subluxed or dislocated. The costotransverse joint is the more likely of the two to be injured. The first costotransverse joint is especially vulnerable because of its unique position at the top of the rib cage. Three cases are presented to show various injuries to this joint.