Presentation
Slipped on bathroom and fell on bottom with persistent pain since 9 days.
Patient Data
Unilateral left-sided sacralization of L5 vertebra.
The coccyx couldn't be well-assessed due to bowel content and excess body fat.
Coccygeal edema, suggestive of a fracture.
L4-5 diffuse posterior disc bulge.
Unilateral left-sided sacralization of L5 vertebra.
Right parasagittal vertical fracture line is seen along the coccyx.
Unilateral left-sided sacralization of L5 vertebra with articulation with the left ala of the sacrum. It is considered type 2a according to Castellvi classification of lumbosacral transitional vertebrae.
Case Discussion
Coccygeal fracture is best assessed on CT. It is more common to be horizontal than vertical fractures. It is hard to be diagnosed on pelvic x-rays and the treatment is usually conservative.