Seated MRI for Patients with Tailbone Pain: a Case Series

Physical Medicine and Rehabilitation

2009 Sept; 1 (9): S223-S224

Patrick M. Foye, M.D., Renee Enriquez, M.D., Evish Kamrava, M.D.

Coccyx Pain Service, Department of Physical Medicine and Rehabilitation, UMDNJ: New Jersey Medical School, 90 Bergen St., DOC-3100, Newark, NJ 07103-2499. Phone: (973)972-2802. Fax: (973)972-2825. tailbonedoctor.com/.

Abstract

OBJECTIVE: To assess the radiologic findings obtained via seated MRI (magnetic resonance imaging) of the sacrum and coccyx in patients with tailbone pain. This is believed to be the first case series ever reported of seated (weight bearing at the coccyx) MRI in a group of patients with a primary complaint of tailbone pain.

DESIGN: Retrospective chart review of MRI results.

SETTING: Academic-based physiatric outpatient pain management practice with a dedicated Coccyx Pain Service.

PARTICIPANTS: 12 patients (7 female and 5 male, average age 45.9 years) with coccydynia (tailbone pain) who had undergone seated MRI of the sacrum and coccyx. Clinically, all 12 patients had a chief complaint of focal coccygeal pain, including coccydynia while sitting. 10 of these patients also had increased coccygeal pain during the transition from sit-to-stand. All 12 had physical exam findings of focal coccygeal tenderness.

MAIN OUTCOME MEASURES: Radiologic findings noted via positional (seated) MRI.

RESULTS: Results of seated MRI on these 12 patients with coccydynia revealed notable coccygeal listhesis in 6, luxation in 5, hypermobility in 1, fracture in 1, bone spur in 1, and normal findings in 1. Meanwhile, 5 studies revealed other findings, e.g. coccygeal fusion or incidental sacral Tarlov cysts. Some patients had more than one abnormality.

CONCLUSIONS: Seated MRI studies of the coccyx region often detect coccygeal abnormalities in patients with coccyx pain.

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