Anterior angulation of the coccyx
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At the time the article was created Usman Bashir had no recorded disclosures.
View Usman Bashir's current disclosuresAt the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai'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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