The coccyx is bordered anteriorly by the levator ani muscle and the sacrococcygeal ligament. The lower part of the filum terminale, also called the coccygeal ligament, inserts onto this first segment. In addition, the first coccygeal segment contains rudimentary articular processes called the coccygeal cornua that articulate with the sacral cornua. 3, 5, 6 The coccyx is a triangular bone that consists of 3 to 5 fused segments, the largest of which articulates with the lowest sacral segment. The word coccyx is derived from the Greek word for the beak of a cuckoo bird because of the similarity in appearance when the latter is viewed from the side. doi:10.1148/rg.The coccyx is the terminal segment of the spine. Skalski M, Matcuk G, Patel D, Tomasian A, White E, Gross J. Clinical and radiological differences between traumatic and idiopathic coccygodynia. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Coccygectomy for coccygodynia: does pathogenesis matter?. Pennekamp PH, Kraft CN, Stütz A, Wallny T, Schmitt O, Diedrich O. Coccygectomy for coccydynia: case series and review of literature. Balain B, Eisenstein SM, Alo GO, Darby AJ, Cassar-Pullicino VN, Roberts SE, Jaffray DC. (1991) The Journal of bone and joint surgery. (2004) The Journal of the American Academy of Orthopaedic Surgeons. (1983) The Journal of bone and joint surgery. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. Infection including shingles of the buttocks Differential diagnosisĬauses of pain in the coccygeal region include: It is also called the "tailbone" because it is located anatomically at the end of the vertebral column below the sacrum. The term was used in practice for the first time by Simpson in 1859, although was described as early as 1600s. The word coccyx originates from the Greek word "cuckoo" ( kokkyx), on the basis of resemblance to the structure a cuckoo's beak. Limited coccygectomy may to resect a mobile segment 5 Removal of the coccyx by surgery either partial or total (coccygectomy) in refractory cases Radiofrequency ablation of coccygeal discs and ganglion impar Injections of local anesthetic and steroid Large draining vein on the ventral coccyxĪny inflammation or soft tissue abnormalities around the coccyxĬonservative treatment includes rest, coccygeal cushion, physiotherapy and massage. In traumatic coccydynia the joint may heal spontaneously over weeks or months Presence of fluid collection within the sacrococcygeal synchondrosis Rigid coccyx with a spicule or spur at its tipīursa along the dorsal surface of the coccyx Superior than standard radiograph because it can detect measurement of the sagittal rotation of the pelvis and the coccygeal angle of incidence Normal pivot of the coccyx lies between 5 and 25°ĭynamic stress films or weight bearing radiograph Useful radiological assessment to evaluate the anterior angulation of the coccyx and its deformity In idiopathic coccydynia was greater than that of traumatic Intercoccygeal angle ( between the first and last segment of the coccyx) Number and morphology of coccygeal segments Two types of radiographs:Ĭoccyx scoliotic deformity (AP and lateral) Plain radiographyĬonsidered the first line of imaging of painful coccyx ref required. Inflammation/infection of the coccyx (rarely)Ĭoccydynia is essentially a clinical diagnosis, but imaging modalities are helpful in assessment and possible identification of the etiology. Partial dislocation of the sacrococcygeal synchondrosis Rigid coccyx with abnormal features at its tipĪnterior and posterior subluxation of the coccyx 7 However, pain is extremely varied and may be related to sitting, bowel movements, radiculopathic or generalized coccygeal pain. Osteoporosis and other degenerative bone diseasesĪs the name suggests, pain is considered to be the primary symptom of coccydynia. No accurate data about the frequency of coccydynia is reported, but one study found that coccydynia accounted for 2.7% of all backache cases presenting to the hospital 8. It is approximately five times more common in females than males.
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