E2233. Tale of the Tail: Role of Imaging in Painful Coccyx
Bhari Thippeswamy Pushpa;
N. Rajarama Ravivarma;
The term coccydynia refers to symptoms of pain in the region of the coccyx. Although local trauma is the most common cause of coccydynia, various other causes like idiopathic, repetitive microtrauma, childbirth, infection, and tumors are also implicated. A surgical procedure like coccygectomy is reserved for extreme cases.
Educational Goals / Teaching Points
1. To study the morphology and morphometry of painful adult coccyx
2. Role of multimodality imaging for chronic coccydynia
3. Role of Interventional Radiology in the management of chronic coccydynia
4. Reporting template for chronic coccydynia
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
When the clinical suspicion of coccydynia is made, the first-line investigation includes standard and dynamic radiographs. Standard lateral radiograph helps to study coccygeal configuration, dynamic radiographs determine the extent of the mobility of the coccyx. When there is diagnostic ambiguity in the radiograph, Magnetic Resonance Imaging plays a key role in detecting subtle marrow changes and soft tissue changes around the coccyx.
At our institute, Computed tomography is reserved for imaging suspected fractures when the radiograph is equivocal. Computed tomography also plays a major role in the guided injection of local anesthetic and corticosteroid mixture targeting sacrococcygeal joint or ganglion impar, when conservative management fails.
This exhibit familiarises the reader about coccygeal morphology and morphometry in coccydynia and the role of multimodality imaging in its diagnosis and treatment.