Summary
Definition
History and exam
Key diagnostic factors
- dor coccígea
- sensibilidade à palpação coccígea
- espasmo da musculatura do assoalho pélvico
- alívio dos sintomas após a injeção de corticosteroides
Other diagnostic factors
- defesa
Risk factors
- sexo feminino
- história de trauma do cóccix
- obesidade
Diagnostic investigations
1st investigations to order
- radiografia sacrococcígea lateral
- radiografias sacrococcígeas laterais dinâmicas
Investigations to consider
- RNM do sacro e do cóccix
- tomografia computadorizada (TC) da coluna lombossacral
- contagem leucocitária
- velocidade de hemossedimentação
Treatment algorithm
novo diagnóstico: doença aguda ou crônica
sintomas ≥2 meses e manejo do quadro agudo malsucedido
Contributors
Authors
Rudolph J. Schrot, MD, MAS, FAANS
Neurosurgeon
Sutter Medical Group
Sacramento
CA
Disclosures
RJS has been an expert witness for personal injury defense, is a primary investigator on two industry sponsored studies, and has given medical lectures.
Peer reviewers
Patrick M. Foye, MD
Professor and Director of the Coccyx Pain Center
Rutgers New Jersey Medical School
Newark
NJ
Disclosures
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
Disclosures
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.
References
Key articles
Skalski MR, Matcuk GR, Patel DB, et al. Imaging coccygeal trauma and coccydynia. Radiographics. 2020 Jul-Aug;40(4):1090-106.Full text Abstract
Fogel GR, Cunningham PY, Esses, SL. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004;12:49-54. Abstract
Wray CC, Easom S, Hoskinson J. Coccydynia. Aetiology and treatment. J Bone Joint Surg (Br). 1991;73-B:335-338.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Espondilose lombar/hérnia de disco
- Proctalgia fugaz
- Síndrome do músculo elevador do ânus
More DifferentialsPatient information
Dorsalgia: perguntas a fazer ao seu médico
Dorsalgia (coluna lombar)
More Patient information
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