Congenital coccydinia or megalococcyx

Proceedings of the Royal Society of Medicine

1927 Dec; 21(2): page 224.

Higgins TT.

The patient was a girl, aged 5 years, who had never been able to sit down with comfort. Latterly the mother had noticed the skin red and sore. On examination, there were obvious signs of pressure and irritation in the skin overlying the tip of the coccyx. There was a well-marked post-anal dimple and the coccyx itself was quite remarkably prominent. The radiograms showed the upper two segments of the bone ossifying, but the exact extent of the cartilaginous portion was only dimly shown in the negative.

Mr. Higgins considered this to be a case of considerable interest from the clinical and embryological point of view. The coccyx occasionally possessed five segments instead of the usual four, but he had never seen or heard of a case with such well-marked clinical discomfort as this. It was possible, as had been suggested to him by the President, that some developmental error in connexion with the closure of the neurenteric canal might offer an explanation. The treatment required was clear, at any rate, namely, a partial extirpation of the coccyx.

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