Spine Case 4 Diagnosis

Diagnosis of coccyx fractures is primarily clinical. There is marked tenderness with direct palpation of the coccyx.

Plain films miss many coccyx fractures or may be confusing if the patient has an anatomic variant or prior trauma. The lateral view is most helpful, and deformity or angulation can be accentuated with a seated lateral view.

CT and MRI add little useful information in coccyx fractures, but are useful in assessing foramenal involvement in sacral fractures.