Skalski Matthew R, Matcuk George R, Patel Dakshesh B, Tomasian Anderanik, White Eric A, Gross Jordan S
From the Department of Radiology, Palmer College of Chiropractic-West Campus, 90 E Tasman Dr, San Jose, CA 95134 (M.R.S.); Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, Calif (G.R.M.); and Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, Calif (D.B.P., A.T., E.A.W., J.S.G.).
Radiographics. 2020 Jul-Aug;40(4):1090-1106. doi: 10.1148/rg.2020190132.
The coccygeal region has complex anatomy, much of which may contribute to or be the cause of coccyx region pain (coccydynia). This anatomy is well depicted at imaging, and management is often dictated by what structures are involved. Coccydynia is a common condition that is known to be difficult to evaluate and treat. However, imaging can aid in determining potential causes of pain to help guide management. Commonly, coccydynia (coccygodynia) occurs after trauma and appears with normal imaging features at static neutral radiography, but dynamic imaging with standing and seated lateral radiography may reveal pathologic coccygeal motion that is predictive of pain. In addition, several findings seen at cross-sectional imaging in patients with coccydynia can point to a source of pain that may be subtle and easily overlooked. Radiology can also offer a role in management of coccygeal region pain with image-guided pain management procedures such as ganglion impar block. In addition to mechanical coccyx pain, a host of other conditions involving the sacrococcygeal region may cause coccydynia, which are well depicted at imaging. These include neoplasm, infection, crystal deposition, and cystic formations such as pilonidal cyst. The authors review a variety of coccydynia causes, their respective imaging features, and common management strategies.RSNA, 2020.
尾骨区域解剖结构复杂，其中许多结构可能导致尾骨区域疼痛（尾骨痛）或成为其病因。这种解剖结构在影像学上显示清晰，治疗方案通常取决于受累的结构。尾骨痛是一种常见病症，已知其评估和治疗都很困难。然而，影像学检查有助于确定疼痛的潜在原因，以指导治疗。通常，尾骨痛在创伤后出现，静态中立位X线摄影显示影像特征正常，但站立位和坐位侧位动态X线摄影可能显示病理性尾骨活动，这可预测疼痛。此外，在尾骨痛患者的横断面成像中发现的一些表现可能指向疼痛来源，这些来源可能很细微且容易被忽视。放射学在尾骨区域疼痛的治疗中也能发挥作用，例如通过神经节阻滞等影像引导下的疼痛管理程序。除了尾骨机械性疼痛外，许多涉及骶尾骨区域的其他病症也可能导致尾骨痛，这些在影像学上都有很好的显示。这些病症包括肿瘤、感染、晶体沉积以及囊肿形成，如藏毛窦。作者回顾了各种尾骨痛的病因、各自的影像学特征以及常见的治疗策略。RSNA，2020年。
