CT-diagnosis of traumatic injury of sacro-coccygeal joint

R.R. Mukhamedrakhimov, R.U. Smakaev

European Congress on Radiology 1999

Abstract

In cases of coccygodynia pain may last for years, defying treatment.

Analysing the mechanism of coccygeal fracture we came to opinion that not only coccygeal bone injures, causing vertebra dislocation, but sacrococcygeal joint (SCJ) too.

And very rarely the pathology of SCJ one can see X-ray photos of coccyx. Traditional X-ray image does not give full information about volumentrical state of coccyx and surrounding tissues.

CT-examination was performed in order to confirm the SCJ's injury of 30 patients with coccygeal fracture. In the process the state of bone structure of coccyx, ligamentous apparatus and surrounding soft tissues was assessed. The results of examinations showed than all patients have got changes in SCJ, and surrounding tissues of different extent. Incomplete dislocations of SCJ, narrowings of inter articular space, osteophytes, induration and heterogeneity of surrounding tissues were determined. One main find that extent of changes is proportional to the distance back in time-talking of traumas of long standing.

All patients had been operated, and subsequent morphologic examinations of removed coccygeal bones confirmed changes had been revealed by CT. Thereby, all coccygeal fractures are accompanied by SCJ's injury and coccygectomy should be carried out, not simple resection of fractured fragment, which does not relieve the source of pain in the region of SCJ.

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