Tailbone x-ray

, medical expert
Last reviewed: 25.02.2021

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Such a diagnostic study as an x-ray of the tailbone is not prescribed very often, but only if the patient complains of discomfort or pain in this part of the spine. The study itself is not complicated and can be performed in almost any polyclinic institution that has X-ray equipment. Coccyx X-ray is an informative diagnostic method that helps to identify many osteoarticular pathologies in the corresponding area of the spinal column.

Indications for the procedure

X-rays are a common diagnostic method based on the use of a gamma ray. The method is so popular and affordable that it is used in almost any clinic and in private medical and diagnostic institutions. And this is not surprising, because X-ray has a number of advantages, such as efficiency (information content), ease of implementation and affordability.

A tailbone x-ray is prescribed in case of suspicion of trauma to the specified area, or an inflammatory process. It is possible to highlight the indications for performing this study in the following list:

  • severe hemorrhage in the coccyx area;
  • pain, feeling of pressure or numbness in the coccyx area; [1]
  • visible vertebral displacement in the lower back;
  • suspicion of dislocation, subluxation or fracture of the tailbone;
  • diseases of the pelvic organs;
  • disorders of urination or defecation;
  • limited motor ability in the lower back;
  • feeling of stiffness in the lower limbs;
  • suspected intervertebral hernia;
  • inflammatory diseases of the lower spine;
  • suspicion of oncopathology.

A tailbone x-ray for prophylaxis can only be prescribed for patients who, due to professional or other characteristics, are forced to spend a long time in a sitting position. Without fail, the study is performed on people who have fallen from a height on their legs or lower back.

A tailbone x-ray is also relevant for degenerative processes in this area.


A tailbone x-ray is a technically simple procedure. Nevertheless, you need to prepare for it in advance - except in cases of emergency, when patients are taken to the emergency room with severe injuries.

With a planned X-ray of the coccyx, it is better to preliminarily prepare for the study. This is necessary to ensure that reliable information is obtained in the image.

Preparation consists of the following stages:

  • 2-3 days before the X-ray of the tailbone, it is necessary to revise your diet and exclude heavy (fatty, difficult to digest) dishes from it, as well as foods that can cause fermentation and increased gas formation in the intestines. It is advisable to temporarily abandon peas, white cabbage, sweets and yeast baked goods, mineral water, dried fruits, whole milk. It is important not to overeat these days.
  • The day before the study, the intestines are cleaned with an enema. You can use clean warm water or chamomile infusion. In case of strong accumulations of feces, it is additionally allowed to take a laxative drug (for example, Duphalac).
  • On the eve of the procedure, light meals are allowed. But it is better to go for diagnostics with an empty stomach.

When going to the X-ray room, you should leave all metal accessories and jewelry at home. It is advisable to wear comfortable clothes that can be easily removed and no less easy and quick to put on. If there are non-removable metal implants that may interfere with the study, it is better to immediately inform the doctor about them.

Enema before a tailbone x-ray

Cleansing the intestines before taking a coccyx x-ray is an important measure to ensure the quality of the image. Of course, you can take a picture without first setting an enema, but in such a situation there will be a risk of some image distortion.

An enema before an X-ray is not performed:

  • in emergency cases in the serious condition of the patient;
  • with fever, high body temperature;
  • with diarrhea;
  • with inflammatory bowel diseases (including the rectum);
  • with pain in the abdomen, nausea of unknown origin;
  • after a recent heart attack or stroke;
  • with internal bleeding.

If an enema is nevertheless indicated, then it is optimal to perform it with the help of an Esmarch mug - a capacious vessel that rises to a certain height, creating optimal water pressure.

Intestinal cleansing with an enema method is performed with warm clean water or herbal infusion (chamomile, calendula). The volume of fluid used is directly proportional to body weight: the greater the weight, the more fluid is used. As a rule, for one enema for an adult, 1 to 2 liters of water is enough. [2]

Here's how the enema is administered:

  • the enema system is filled with liquid;
  • clamp the tube and hang the container with water at the optimal height;
  • prepare a place for the procedure - for example, cover oilcloth;
  • apply a little petroleum jelly or vegetable oil to the tip;
  • the patient lies on his side or takes a knee-elbow position, after which an enema tip (about 8-10 cm) is inserted into the rectum, the clamp is released and the required volume of fluid is gradually poured in;
  • then the tip is removed;
  • the patient, if possible, should retain fluid in the intestine for at least five minutes.

If at any stage the patient's well-being worsens, pains appear, etc., then the procedure is stopped.

For a more comfortable performance of an enema bowel cleansing, you should pay attention to the following points:

  • if pain occurs during the introduction of water into the intestine, it is necessary to weaken the flow rate;
  • do not use cold and hot water for an enema (optimally - from +27 to + 38 ° C);
  • be sure not to forget about lubricating the tip with petroleum jelly or vegetable oil;
  • it is important to perform the procedure smoothly, without haste, calmly.

If there are any problems with setting an enema before an x-ray of the tailbone, or there are contraindications, then you can consult a doctor: in some cases, it is allowed to cleanse the intestines with laxatives or microclysters (Mikrolax, etc.).

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Technique of the tailbone x-ray

A tailbone x-ray usually covers the sacrococcygeal area. The study is performed in a horizontal position: the patient is placed on a special couch (table). It is possible to obtain images from different positions or positions of the body, which is discussed in advance with the doctor:

  1. X-ray of the coccyx in a direct posterior projection is performed as follows. The patient lies on his back, bends his legs at the knee and hip joints (or only at the knees). The arms are extended along the body.
  2. A lateral x-ray of the coccyx is performed from a lateral position. The patient raises the upper limbs and brings them behind the head. The lower limbs are at a slight angle.
  3. Oblique projection is rarely used and only to clarify the functionality of a particular joint.

During the X-ray, the doctor may take one or two pictures. If there are difficulties in visualizing individual segments and joints, the doctor can refer the patient for ancillary diagnostics, for example, MRI or computed tomography. [3]

How is a tailbone x-ray done?

Immediately before the x-ray of the coccyx, the patient enters the office, frees himself from all metal objects and accessories (watches, chains, piercing jewelry, etc.), takes off clothes that may interfere with obtaining an image of the required area of the body.

Then the patient lies down on a special table or couch with an X-ray machine in such a way that the scanning device is over the lower back. If necessary, a specialist radiologist will correct the position and give appropriate recommendations.

During the procedure, images are taken in the required projection. If there are several such projections, then the doctor will inform the patient about the need to change the position of the torso.

As a rule, the entire diagnostic session with a tailbone x-ray takes no more than 15 minutes.

After the procedure, the radiologist develops the film, examines the picture, draws up a description and gives the results to the patient's hands or sends it to the attending doctor who previously issued the referral to the patient. In turn, the attending physician, based on the results of the diagnosis, establishes the final diagnosis and prescribes the appropriate treatment. [4]

What does a tailbone x-ray show?

A tailbone x-ray helps to look at traumatic injury or inflammation. Most often, with its help, the following pathologies are diagnosed:

  • Coccyx hematoma is the effusion of blood in the tissue due to injury. Hemorrhage in this area, as a rule, does not resolve, therefore, minor surgical intervention may be required - first of all, to exclude the development of an inflammatory process with suppuration. A tailbone x-ray in this case helps the doctor assess the severity of the injury and the likelihood of complications.
  • Sacral dislocation is a pathological deformity caused by injury to the coccyx. The main signs of pathology are considered to be pronounced external displacement, pain when probing, swelling and clicks (crunching) when trying to move.
  • Coccyx fracture is one of the most difficult traumatic pathologies, which can be open or closed. With an open fracture, there is a strong pain syndrome, and a closed fracture is accompanied by symptoms of varying intensity, depending on the complexity of the injury. Often, on the x-ray of the tailbone, it is not possible to thoroughly examine the problem, so the doctor additionally prescribes computed tomography.

During the X-ray of the coccyx, other pathologies can also be detected - in particular, tumors, osteochondrosis, inflammation, hernial protrusions, etc. [5]

Fracture of the tailbone on x-ray

A tailbone fracture can be the result of a fall on a hard surface (asphalt, tiles, ice), or the result of a direct direct impact. Women sometimes get a tailbone injury during childbirth. It is believed that female patients are more likely to suffer from similar injuries, primarily due to the wider hips. It turns out that the tailbone in women is more vulnerable.

Fracture of the tailbone is accompanied by severe pain: it is almost impossible to sit. Hematomas can form in the lower back, and pain bothers, including during bowel movements. With slight damage, painful sensations are noted during sexual intercourse.

Fracture of the coccyx is often combined with dislocation (they say so - "fracture dislocation"), with displacement of fragments depending on the direction of the damaging force in relation to the axis of the coccyx, which becomes noticeable on x-ray. When displaced, muscles and ligaments are usually damaged.

Coccyx contusion on x-ray

It often happens that people fall and injure the lowest segment of the spine - the tailbone. This area is a series of interconnected vertebrae, which in our ancestors was nothing more than a part of the tail. Experts attribute the tailbone to one of the most vulnerable parts of the spine. That is why bruises in this area are often diagnosed in patients of any age, and especially in winter - on ice.

A small bruise of the tailbone, as such, is not displayed on the x-ray. The study is carried out in order to exclude more complex injuries of the spinal segment - in particular, a fracture (which, by the way, happens relatively rarely) or dislocation. The scale of therapeutic measures will depend on the results of the x-ray of the coccyx.

Angular deformity of the coccyx on x-ray

A severe bruise of the tailbone can be accompanied by a sharp deviation of it in the direction directly opposite to the direction of the action of the traumatic factor. In this case, the sacrococcygeal ligaments remain intact. A lighter traumatic effect is accompanied by the return of the coccygeal vertebrae immediately after the end of the influence of the damaging force.

If an extensive hematoma forms in the area of injury, then it can squeeze the surrounding tissues and nerve endings, which entails not only the appearance of pain, but also angular deformation of the coccyx. If the formation of scar tissue occurs in the specified area, then such a deformation becomes protracted (chronic), which is clearly seen on an X-ray.

With partial damage to the sacrococcygeal ligamentous apparatus against the background of a hematoma, the joint of the same name can be destabilized, as a result of which its mobility increases.

Contraindications to the procedure

In case of emergency, a tailbone x-ray is prescribed with almost no restrictions. However, there are potential risks. For example, research is not recommended for:

  • during pregnancy and breastfeeding;
  • with diagnosed tuberculosis (regardless of the stage of the process);
  • patients with mental disorders;
  • patients with severe obesity.

Early childhood, acute diseases of the cardiovascular system, and diseases of the thyroid gland can become relative contraindications.

Too frequent X-rays are not recommended (optimal - 1-2 times a year). [6]

What's better? X-ray or MRI of the tailbone?

Patients who are faced with the need to assess the condition of the coccyx often wonder: which is better, more informative and safer - X-ray or magnetic resonance imaging? Indeed, these diagnostic methods are very different, and every patient must have an idea of this.

MRI is used to diagnose various tissue pathologies. Thanks to MRI, it is possible to assess the state of internal organs, soft tissue and vascular structures, to determine benign or malignant tumor processes. The main difference between MRI and X-ray is the ability to obtain images of organs in the required plane and with a three-dimensional image.

X-rays are prescribed to detect disorders of the musculoskeletal system, therefore, in case of tailbone injuries, this study is more appropriate. In addition, X-ray diagnostics are more affordable and less expensive than expensive MRI. [7]

If we talk about harmfulness, then X-ray radiation is certainly more harmful - if it is carried out often, or if you take many pictures at the same time in different projections. But MRI is not done for patients with claustrophobia and fixed metal implants. Considering all the pros and cons, we can say the following: if you need to diagnose an uncomplicated injury and take only 1-2 pictures, then it is more expedient to take an X-ray of the tailbone. MRI is indicated for complex diseases involving soft tissues and blood vessels.

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