The coccyx AP view is used to demonstrate the coccyx, in conjunction with the sacrum and coccyx (lateral view). Follow departmental protocol in relation to imaging this region.
- the radiograph is performed with the patient in a supine position, with arms placed comfortably by their side, legs extended 1
- AP view
- 5 cm superior to the pubic symphysis at the MSP 1
- angled 10 degrees caudal 1
- must adhere to the ALARA principle given the region exposed via the primary beam
- close collimation to the area of interest
- adequate penetration should clearly demonstrate the coccyx region
- the coccyx is free of superimposition from the pubic rami
- lateral margin of the coccyx is equidistant from the pelvic brim indicating no patient rotation
- given the proximity of this anatomy to the gonadal region, risk versus benefit of ionising radiation and diagnostic value should be considered before imaging occurs 2
- if imaging is required, the urinary bladder and large colon should be emptied before this examination to minimise superimposition of structures over the coccyx region 1
- 1. Bontrager Kenneth L, John P Lampignano and Kenneth L Bontrager. Bontrager's handbook of radiographic positioning and techniques. 1st ed. St. Louis, Mo.: Mosby/Elsevier, 2010.
- 2. Hanna Tarek N., Mahniya Sadiq and Noah Ditkofsky et al. "Sacrum and Coccyx Radiographs Have Limited Clinical Impact in the Emergency Department". American Journal of Roentgenology 206, no. 4 (2016): 681-686. . doi:10.2214/ajr.15.15095.