Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- dor coccígea
- sensibilidade à palpação coccígea
- espasmo da musculatura do assoalho pélvico
- alívio dos sintomas após a injeção de corticosteroides
Outros fatores diagnósticos
- defesa
Fatores de risco
- sexo feminino
- história de trauma do cóccix
- obesidade
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- radiografia sacrococcígea lateral
- radiografias sacrococcígeas laterais dinâmicas
Investigações a serem consideradas
- RNM do sacro e do cóccix
- tomografia computadorizada (TC) da coluna lombossacral
- contagem leucocitária
- velocidade de hemossedimentação
Algoritmo de tratamento
novo diagnóstico: doença aguda ou crônica
sintomas ≥2 meses e manejo do quadro agudo malsucedido
Colaboradores
Autores
Rudolph J. Schrot, MD, MAS, FAANS
Neurosurgeon
Sutter Medical Group
Sacramento
CA
利益声明
RJS has been an expert witness for personal injury defense, is a primary investigator on two industry sponsored studies, and has given medical lectures.
同行评议者
Patrick M. Foye, MD
Professor and Director of the Coccyx Pain Center
Rutgers New Jersey Medical School
Newark
NJ
利益声明
PMF is the author of references cited in this topic.
Birender Balain, MBBS, FRCS, FRCS (Tr and Orth)
Specialist Registrar
Robert Jones and Agnes Hunt Orthopaedic and District Hospital
Oswestry
UK
利益声明
BB is the author of some studies referenced in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Skalski MR, Matcuk GR, Patel DB, et al. Imaging coccygeal trauma and coccydynia. Radiographics. 2020 Jul-Aug;40(4):1090-106.全文 摘要
Fogel GR, Cunningham PY, Esses, SL. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004;12:49-54. 摘要
Wray CC, Easom S, Hoskinson J. Coccydynia. Aetiology and treatment. J Bone Joint Surg (Br). 1991;73-B:335-338.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Espondilose lombar/hérnia de disco
- Proctalgia fugaz
- Síndrome do músculo elevador do ânus
更多 鉴别诊断患者教育信息
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Dorsalgia (coluna lombar)
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