Diagnosis of Coccydynia

A health professional diagnoses coccydynia by taking a thorough medical history from the patient and completing a physical examination. Diagnostic tests, such as x-ray or MRI, are also commonly performed in order to rule out other potential causes of the pain.

A thorough physical examination should include:

• Pelvic and rectal exam to check for a mass or tumor that could be a cause of the pain
• Palpation to check for local tenderness.

The most striking finding on examination is usually the local tenderness upon palpation of the coccyx. If the coccyx is not tender to palpation, then the pain in the region is referred from another structure, such as a lumbosacral disc herniation or degenerative disc disease.

Diagnostic studies that should be done include:

• X-rays of the sacrum and coccyx should be done to rule out the unlikely event that either an obvious fracture or a large tumor is the cause of the discomfort.
• An MRI scan is useful to rule out infection or tumor as a cause of pain

Bone scans and CT scans add very little information and are generally not done. Typically, all imaging studies will be negative.

• Article written By:
• Richard Staehler, MD

April 4, 2000

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