Anterior angulation of the coccyx
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View Ashesh Ishwarlal Ranchod's current disclosures- Forward angulation of the coccyx
- Anterior deformity of the coccyx
- Anterior angulation of coccyx
Anterior angulation of the coccyx may be a normal variant but poses a diagnostic challenge for those considering coccygeal trauma 1.
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Classification
Six types of coccyx have been described initially by Postacchini and Massobrio and later modified by Nathan et al. 2,3:
type I: the coccyx is curved slightly forward, with its apex pointing caudally (~70%)
type II: the coccyx is curved more markedly anteriorly, with its apex pointing straight forward (~15%)
type III: the coccyx is sharply angulated forward between the first and second or the second and third coccygeal segments (~5%), or less commonly due to angulation at the S5 segment
type IV: the coccyx is subluxed anteriorly at the level of the sacrococcygeal joint or at the level of the first or second intercoccygeal joints (~10%)
type V: the coccyx is retroverted or has a posterior spicule
type VI: the coccyx is scoliotic (lateral deviation)
Radiographic features
The intercoccygeal angle is a useful radiological assessment to evaluate the anterior angulation of the coccyx and its deformity.
Related pathology
Patients with a type II-IV coccyx are more prone to develop idiopathic coccygodynia than those with a type I configuration ref. Partial or total coccygectomy usually provides relief in these cases ref.
Quiz questions
References
- 1. Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am. 1983;65 (8): 1116-24. J Bone Joint Surg Am (link) - Pubmed citation
- 2. Skalski M, Matcuk G, Patel D, Tomasian A, White E, Gross J. Imaging Coccygeal Trauma and Coccydynia. Radiographics. 2020;40(4):1090-106. doi:10.1148/rg.2020190132 - Pubmed
- 3. Nathan S, Fisher B, Roberts C. Coccydynia. The Journal of Bone and Joint Surgery British Volume. 2010;92-B(12):1622-7. doi:10.1302/0301-620x.92b12.25486 - Pubmed
Incoming Links
- Coccydynia
- Intercoccygeal angle (illustration)
- Anterior angulation of the coccyx and bilateral accessory sacroiliac joints
- Anterior angulation of the coccyx
- Anterior angulation of coccyx - type I
- Anterior angulation of the coccyx - type IV
- Anteriorly angulated coccyx
- Anterior angulation of the coccyx
- Intercoccygeal angle measurement
- Forward angulation type III coccyx
- Coccydynia
- Anterior angulation of the coccyx
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