The Fourth Thoracic Vertebra T4 of a Male Viewed Anteriorly

Description

Anteriorly, the T4 vertebra is centered in the upper thoracic spine, its vertebral body broad and slightly heart-shaped relative to cervical levels, with the superior and inferior vertebral endplates separated from adjacent levels by intervertebral discs. Along the superolateral and inferolateral margins of the vertebral body, the superior and inferior costal demifacets (foveae costales superiores et inferiores) mark the articulations for the head of the fourth rib and the adjacent rib. Pedicles arise posterior to the vertebral body and lead into the vertebral arch, while the transverse processes project laterally, setting the stage for the costotransverse joint at this level even if the tubercular facet is not the focus in an anterior projection. One segment is color-highlighted to localize T4 within the sequence. T4 matters because it sits near the transverse thoracic plane (sternal angle level, classically T4 to T5), a common internal reference used for mediastinal anatomy and for counting vertebral levels on imaging. Those costal demifacets are a frequent source of confusion when learners expect a single full facet, and they are clinically relevant in thoracic spondylosis or inflammatory arthropathy where the costovertebral joints contribute to pain with respiration. Fracture morphology also changes here. Upper thoracic compression fractures can be missed without careful attention to endplate contour and disc spacing on lateral radiographs and CT. Use this anterior T4 view for teaching thoracic vertebral identification in gross anatomy, osteology labs, and radiographic anatomy modules that pair vertebral landmarks with rib articulation points. It also suits textbook figures on the costovertebral and costotransverse joints, and patient-facing surgical education where level localization for thoracic epidural placement or vertebral augmentation must be explained without posterior elements dominating the frame. Anatomical accuracy verified by SciePro's Medical Advisory Board.