Tailbone-Coccyx Fractures and Dislocations, Last Chapter in New Medical Textbook

New Book Chapter on Coccyx  Fractures and Tailbone Dislocations, Last Chapter in New Medical Textbook
  • In this video, Dr. Foye discusses the chapter he wrote on Tailbone Fractures and Coccyx Dislocations.
  • This is the very last chapter in a recently published medical textbook.
  • Patrick Foye, M.D., is director of the Coccyx Pain Center at Rutgers New Jersey Medical School.
  • Dr. Foye has many publications in medical journals and medical textbooks, especially on the topic of coccyx injuries and tailbone pain. He also lectures on this topic within the United States and internationally.
  • This book chapter will help physicians understood more about how to evaluate and treat fractures and dislocations of the coccyx.
Here is the TEXT from the video: (The actual VIDEO is lower down on this webpage.)
  • This video is about a new medical textbook that just came out (it’s 2018) with a chapter about coccyx dislocations and fractures (tailbone dislocations and fractures).
  • I’m Dr. Patrick Foye.
  • I’m an M.D. or medical doctor.
  • And I’m the Director of the Coccyx Pain Center or Tailbone Pain Center here in the United States.
  • I’m online at www.TailboneDoctor.com.
  • And just within the last couple of months I announced a different medical textbook, which was this one.
  • It was an atlas of spinal injection procedures.
  • And that was one where I had written a chapter on ganglion Impar injections for this medical textbook.
  • But now there is just another one that came into print.
  • This one is not so much on procedures but on general musculoskeletal, sports and spine disorders.
  • And this is a medical textbook mainly for physicians that practice musculoskeletal medicine (that treat sports injuries and other musculoskeletal injuries).
  • And basically the idea of this book is to help those physicians to learn about different topics.
  • And in this book the chapter that I wrote is specifically on coccyx fractures and dislocations.
  • It is the very last chapter in the book.
  • The idea of these chapters that I write in medical textbooks…
  • I’m an academic physician in the sense that I’m full-time faculty at a medical school and educating not only patients but also educating physicians.
  • It’s a large part of what I do as part of my profession, as part of my career, and in this case really trying to spread knowledge about how to evaluate and treat patients with tailbone injuries.
  • So… many, many patients fly in to see me from around the country and occasionally internationally.
  • And very commonly one of the things they’ll say is that their local doctors did not know very much about how to evaluate their coccyx pain (tailbone pain) or coccyx injuries (tailbone injuries) and let alone how to treat them.
  • So in addition to the things that I publish and write for patients I also try of course to continue publishing for other physicians to help them with understanding these conditions as well.
  • So it is the very, very last chapter in this book.
  • So… Chapter 102 out of 102 chapters.
  • So the tailbone comes at the end. But that’s fine because it’s in there.
  • So hopefully this will serve as a valuable resource for physicians.
  • You can see that this chapter is specifically on coccyx fractures and dislocations.
  • This image here showing a fracture at the tailbone and then the text describing all about that.
  • Basically discussing here everything from the definition as far as fracture versus dislocation.
  • The diagnosis of fractures and dislocations.
  • There’s another image here you may like to see.
  • This is showing a dislocation at the coccyx or tailbone right there where the arrow is pointing.
  • Talking about the things to consider…
  • How to make the diagnosis by your history… your physical examination findings…
  • The different types of imaging studies…
  • Getting the appropriate x-rays or MRI or in some cases CT scans bone scans, etc. depending on the specifics in a given patient…
  • And then talking about the different treatment options.
  • So, again… many patients who are watching my videos will know me from either the videos or the online articles that I write, or from the book that I’ve written specifically for patients, which is “Tailbone Pain Relief Now!”
  • But the bulk of what I do over the last twenty some years in academic medicine is actually working to educate physicians as well, which is through textbook chapters and things along those lines.
  • So it is the last chapter but the important thing is that it’s in there to serve as an educational resource for physicians who are evaluating patients with tailbone pain.
  • So this is one book I would recommend certainly if you’re a musculoskeletal physician   interested in learning more about a wide variety of musculoskeletal conditions.
  • This is available through Springer which is a major medical publisher.
  • Or certainly available through your medical textbook bookstores and online of course at Amazon etc.
  • If your patient more interested in reading from a patient perspective.. that book as this is more geared for physicians.
  • This book Tailbone Pain Relief Now! is geared towards patients.
  • And this is 272 pages.
  • And it has chapters specifically on tailbone fractures and chapter on tailbone dislocations as well as a wide variety of other tailbone-related conditions.
  • This book you can get online.
  • The easiest way is by going to www.TailboneBook.com and it will give you the links to the appropriate pages on Amazon in your different countries and things of that nature.
  • You can get the book either as a paperback copy or in an electronic book e-book version.
  • So that’s information about the books and about the new publication.
  • For me it’s always exciting.
  • This project for this textbook I’ve probably been working on for about I’m going to say about three years since I first started or was asked to write the chapter.
  • It takes a relatively long time for things to come to print within the world of medicine.
  • So I just thought I’d share that.
  • It’s always nice when it finally comes in print because that’s when it can go out and make a positive difference hopefully in the world.
  • If you’re interested in coming to see me or find more information that I have about tailbone pain you can find that on my website which is www.TailboneDoctor.com
  • Bye bye.
Here is the video:

Here are photos and screenshots from the video:
Coccyx Fracture and Dislocations, Tailbone Pain, Chapter in Textbook on Musculoskeletal Sports and Spine Disorders, by Patrick Foye MD

Coccyx Fracture and Dislocations, Tailbone Pain, Chapter in Textbook on Musculoskeletal Sports and Spine Disorders, by Patrick Foye MD

Coccyx Fractures and Dislocations, Tailbone Pain, Chapter in Textbook on Musculoskeletal Sports and Spine Disorders, by Patrick Foye MD

Coccyx Fractures and Dislocations, Tailbone Pain, Chapter in Textbook on Musculoskeletal Sports and Spine Disorders, by Patrick Foye MD


To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

News Media Coverage on “Tailbone Pain from Coccyx Injuries on Water Slides”

News Media have been reporting on my recent publication “Tailbone Pain from Coccyx Injuries on Water Slides.”
I hope this raises awareness and education about coccydynia.
Link: https://www.livescience.com/62710-waterslides-can-injure-tailbones.html
Water Slides Cause Coccyx Injuries, Tailbone Pain, News Article from Live Science

Water Slides Cause Coccyx Injuries, Tailbone Pain, News Article from Live Science

To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

Water Slides Causing Tailbone Pain, Coccyx Injuries. Published in The Journal of Emergency Medicine

I am happy to report that The Journal of Emergency Medicine has just published my research article, titled, “Tailbone Pain from Coccyx Injuries on Water Slides: A Case Series.”

Waterslides Causing Coccyx Injuries, Patrick Foye, Journal of Emergency Medicine, 2018

Waterslides Causing Coccyx Injuries, Patrick Foye, Journal of Emergency Medicine, 2018

The Journal of Emergency Medicine has the article available online here:
A preliminary version of this research was previously presented a medical conference. The abstract of that is here:
To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

Reddit AMA: Ask Me Anything about Tailbone Pain, Coccyx Pain, Coccydynia

Reddit AMA: Ask Me Anything about Tailbone Pain, Coccyx Pain, Coccydynia
  • What: Reddit has an AMA (Ask Me Anything) format where I will answer questions online within the Reddit community.
  • Where: Reddit.com AMA. Go to: https://www.reddit.com/r/IAmA/comments/8i7035/iama_tailbone_pain_physician_ask_me_anything/
  • When: Wednesday, May 9, 2018, at 12:00 noon eastern time (New York City time).
  • Why: I already am on Twitter, Google+, Facebook, Pinterest. Reddit is a way to educate a new group of people about tailbone pain.
  • Limitations: I generally avoid giving actual individual medical advice online to those who I have not evaluated in person. But I can provide information and answers that you can discuss with your in-person treating physician.
Watch the VIDEO:

Here is the screenshot thumbnail image for the video:
Reddit, AMA Ask Me Anything about Tailbone Pain, Coccyx Pain, Coccydynia

Reddit, AMA Ask Me Anything about Tailbone Pain, Coccyx Pain, Coccydynia

To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com  or go to Amazon
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

Tailbone Book, Chapter 12: Sympathetic Nervous System Pain of the Coccyx, Causing Tailbone Pain, Coccyx Pain

Tailbone Book, Chapter 12: Sympathetic Nervous System Pain of the Coccyx, Causing Tailbone Pain, Coccyx Pain
  • Is your Tailbone Pain Caused by Sympathetic Nervous System Pain of the Coccyx???
  • This is the next in a series of coccyx pain videos, giving you highlights from the chapters of Dr. Foye’s book, “Tailbone Pain Relief Now!”
The actual VIDEO is at the bottom of this page.
Here is the TEXT from the video:
  • Do you have nerve pain that’s causing your tailbone pain?
  • That’s the topic for this video.
  • I’m Dr. Patrick Foye.  I’m an M.D. or Medical Doctor and I’m the Director of the Coccyx Pain Center or Tailbone Pain Center here in the United States.
  • I’m online at www.TailboneDoctor.com.
  • And this is the next in this series of videos going chapter by chapter through my book Tailbone Pain Relief Now.
  • The idea is to give you highlights of each chapter and provide a format where we can interact and have questions and conversations about the chapter by putting your comments down below the video.
  • So here now we are up to chapter number 12, which is Sympathetic Nervous System Pain at the Coccyx ,or causing tailbone pain essentially.
  • And the idea here is that our pain pathways are set up to sort of sound an alarm system.
  • So if I touch my hand to a hot stove, the pain will signal me to pull my hand away from the stove and then the pain should stop.
  • But sometimes at the tailbone what happens is that somebody has a bone spur or a dislocating bony segment or arthritis and the pain doesn’t stop.
  • The pain is painful every time the person sits.
  • They’re not able to get relief either because their local doctors are not able to give them an accurate diagnosis or an effective treatment plan.
  • So the pain goes on and on day after day week after week month after month.
  • And after a while, the nerves themselves can become hypersensitive and hyper irritable.
  • And at the tailbone there’s a particular type of nerve structure that’s there that’s part of what’s called the “sympathetic nervous system.”
  • And the “sympathetic” nervous system has nothing to do with feeling “sympathy” or empathy for the person that’s having pain.
  • It’s just the medical term for that type of nerve pathway.
  • The sympathetic nervous system is known as the part of the fight-or-flight response.
  • So the idea is that if for example thousands of years ago if a saber-toothed tiger or something were to attack us as humans, then we would have a response where we’re either going to fight it off or we’re going to run away. So, fight or flight.
  • And the idea is that when we have a perceived threat we’re going to react to that.
  • And lots of things happen as part of that sympathetic nervous system: our blood pressure goes up, our heart rate goes up as our heart beats faster to get more blood out to our brain and to our muscles and our pupils get bigger so we can look around and assess the threats.
  • All kinds of chemicals are released in our body. So things like adrenaline, epinephrine is sort of running through our system.
  • So it’s really this sympathetic nervous system response that happens.
  • Now, very interestingly, the entire sympathetic nervous system has this pathway where the sympathetic nervous system is right along the spine on each side right and left.
  • But when it gets down to the tailbone instead of having a right and left ganglion or hub for each of the stopping points along the way for the sympathetic nervous system, there’s just one at the midline and that’s called the ganglion impar.
  • And impar means solitary or unpaired because it does not have a right and a left.
  • It has just the one at the midline and that’s located right at the level of the upper coccyx.
  • So now you have this pathway for sort of sounding the alarm when there’s a threat to you.
  • And the very final train stop (if we want to call the ganglion that)… the very final hub or stop along the way of the sympathetic nervous system ganglion (those chains of nerves that are linked together)… the very final one is right at the front of the tailbone.
  • So you can imagine that if there’s a cause of tailbone pain such as a dislocation, an unstable joint, arthritis in the joint etc, that the local pain driving that irritation in the area can start to have a phenomenon where in addition to the musculoskeletal cause of pain, there can actually also be a nerve pain on top of that.
  • So nerves are hyperirritability or hypersensitivity in that area.
  • So that’s part of the sympathetic nervous system that can be painful at the coccyx.
  • And this becomes really important because if you only treat the musculoskeletal cause of pain without also treating the nerve pain then to the patient they just know that they still have pain.
  • And the doctor and the patient maybe are not aware of why the pain is persisting.
  • So, maybe there was a bone spur or arthritis or a dislocating segment and perhaps there was an anti-inflammatory injection done to help with the musculoskeletal pain and inflammation.
  • But the pain persists and the pain persists in those cases perhaps because the sympathetic nervous system is irritated and nothing was done to quiet that down as well.
  • So, often it can be helpful to, in addition to treating the musculoskeletal cause of the pain, to also put some local anaesthetic such as Lidocaine, etc., on that sympathetic nerve ganglion, that ganglion impar at the coccyx.
  • How you would do that depends. It needs to be “custom done” essentially depending on the specific anatomy of a given patient.
  • I’ve published a number of different techniques for doing this.
  • The original publication was way back in the 1990s by Dr Plancart down in Mexico City.
  • But I’ve more recently published other techniques.
  • This is an area I lecture on quite a bit.
  • But basically, that’s the idea as far as the ganglion impar and sympathetic nervous system pain.
  • Other examples of sympathetic nervous system pain that happen in the body… sometimes people may be familiar with things like R.S.D. or Reflex Sympathetic Dystrophy or Complex Regional Pain Syndrome (sometimes abbreviated as C.R.P.S.).
  • Those are conditions where there’s essentially a hyperactive, irritable sympathetic nervous system causing pain usually in an arm or a leg.
  • And doing a local anesthetic block for that limb, that arm or leg, can give a lot of relief.
  • And, similarly, doing a sympathetic block for patients with a sympathetic nervous system pain at the tailbone can give a lot of relief in that area.
  • So that’s the general idea.
  • There is a lot more information, of course, within the chapter, within the book.
  • So, again, Chapter 12 about that type of nerve pain at the coccyx.
  • If you have further questions or comments on that, definitely post them in the comments down below.
  • I’ll be interested to read those and respond to those and I’m sure others will find your comments helpful as well.
  • If you are looking for a copy of the book, the easiest way to get that is to go online at www.TailboneBook.com
  • And from that web page I have the links to the Amazon sites in different countries and such that you would use to purchase the book, depending on where you are located.
  • You can get the paperback book, the whole thing is two hundred and seventy-two pages.
  • Or you can get it as an e-book, an electronic book which you can basically download for a couple of dollars. And that’s available anywhere in the world where you have internet access. You can get the electronic book and you can read that online, you don’t need any special device other than however you access the internet.
  • So anyway, I hope that that information is helpful for you.
  • If you have questions, again, post them down below.
  • To get the book, go to www.TailboneBook.com.
  • And to find me online or to come for an evaluation here at the Coccyx Pain Center, you can find me by going to www.TailboneDoctor.com.
  • All right, I hope that’s helpful.
  • Bye-bye now.
Here is the actual VIDEO:

Here is the screenshot thumbnail image for the video:
Chapter 12 of Tailbone Pain Book, Sympathetic Nervous System Pain of the Coccyx, Causing Tailbone Pain, Coccyx Pain

Chapter 12 of Tailbone Pain Book, Sympathetic Nervous System Pain of the Coccyx, Causing Tailbone Pain, Coccyx Pain

To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

Second International Symposium on Coccyx Disorders, Netherlands, June 2018

It is just two months until the…

Second International Symposium on Coccyx Disorders
  • Dates: June 29 – 30,  2018
  • Location: Dordrechts Museum, Dordrecht, South Holland, The Netherlands
  • More Information is available at the following website: https://coccyxsymposium2018.com/
Below  (at the bottom of this page) is a VIDEO of Dr. Patrick Foye, M.D., who will be giving lectures at the conference.
  • Dr. Foye will be giving two lectures on non-surgical treatments for coccyx pain (tailbone pain, coccydynia).
  • Dr. Foye will post updated information from the conference, either during or after the coccyx, as much as possible.
Here is the text from Dr. Foye’s video:
  • This video is about the upcoming second International Coccyx Pain Symposium, which will be taking place in the end of June 2018 in the Netherlands.
  • I’m Dr. Patrick Foye. I’m an M.D. or Medical Doctor and Director of the Coccyx Pain Center here in the United States.
  • I’m online at www.TailboneDoctor.com.
  • And this upcoming conference is online at www.Coccyx Symposium2018.com.
  • So, the first International Coccyx Pain Symposium was two years ago in 2016, that was in Paris, France.
  • It was a terrific success. I got to meet clinicians and researchers, anatomy folks etc, from literally around the world who came and spoke at or attended the first International Coccyx Pain Symposium, in Paris.
  • And that was really, really terrific.
  • People whose research I have been reading for years… to be able to meet them in person and really learn a lot from different people in different specialties.
  • And I’m really optimistic that this second International Coccyx Pain Symposium will be a terrific success as well.
  • There is a wide variety of different speakers represented, both physicians and non-physicians and within physicians there are surgeons and non surgeons and other specialties.
  • So it really gives a diverse bunch of different viewpoints as to how different doctors or clinicians in different specialties may approach patients who have similar problems.
  • And really that’s how we all learn from each other.
  • Coccyx pain is a rare and uncommon enough condition that for many of us who treat this we don’t have a lot of other physicians around us who have a lot of experience in treating this as well.
  • So it’s really valuable to have a conference like this where many of us from around the world get together and exchange ideas about the best ways that we can help these patients.
  • The speakers: there’s more than a dozen speakers from literally around the world.
  • So right from within the Netherlands there are a number of physical therapists who be speaking so Pelvic Floor Physical Therapist for example.
  • There is a Colorectal Surgeon from the Netherlands as well.
  • There are Orthopedic Surgeons from both Paris, France, and also elsewhere in France, and two Orthopedic Surgeons will be coming down from Norway.
  • There is a Physical and Manual Medicine and Rheumatology Physician from Paris, France, who is certainly well known for his work in coccyx pain, he will be speaking as well.
  • There is a Physical Medicine Rehabilitation and Pain Physician from Turkey who will be speaking, an Anesthesiology Pain Physician from the United Kingdom who will be speaking, a Chiropractor from the UK as well, a Physicist from the UK who is a patient advocate representing the patient perspective for people suffering with tailbone pain, there is an anatomy PhD researcher who is coming all the way from New Zealand who specializes in some of his research specifically about issues related to the anatomy of the tailbone.
  • And I’m sure there’s others I’m forgetting as well.
  • I’ll be speaking, giving a couple of lectures as well,.
  • So I’ll be coming from the United States.
  • So again, a wide variety of speakers.
  • I’m really looking forward to the conference and I’ll be of course posting information from the conference and maybe doing some live streaming if I have adequate Wi-Fi while I’m there to do so.
  • So if you’re interested in the conference, it’s mostly attended by clinicians but if you have an interest in the coccyx or tailbone pain in general you may be interested in attending, if you’re anywhere able to reach the Netherlands in the end of June.
  • Again, the information for that is online at www.CoccyxSymposium2018.com.
  • Or I’ll be putting more information up about it as it’s upcoming and as I attend the conference myself.
  • And I’ll be posting on my own website, which is www.TailboneDoctor.com.
  • So, hope you can either make the conference or just follow along if you can’t make it.
  • And I’ll update you on things I learn and people I meet and things that go on at the conference in the Netherlands in the end of June.
  • Okay. Bye bye now.
Here is the actual video:

Here is the screenshot from the video:
2nd International Coccyx Pain Symposium, Netherlands, 2018

2nd International Coccyx Pain Symposium, Netherlands, 2018

To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

Should the Coccyx Bones be Fused Together? Does that Cause Tailbone Pain?

Should the Coccyx Bones be Fused Together? Does that Cause Tailbone Pain?
  • There is a lot of variability from person to person regarding fusion of the coccygeal joints.
The Completely Fused Coccyx: A Rigid, Non-mobile Tailbone
  • In some people, the entire coccyx is fused, meaning that the individual bones of the coccyx are fused into one solid bone.
  • When this happens, there is no mobility or movement possible. In that situation, the tailbone is stiff or rigid.
  • A stiff, rigid coccyx is not able to move out of the way when you sit. So, it may be more prone to pressure and pain while sitting.
The Completely Patent Coccyx: a Tailbone where None of the Joints are Fused
  • In other people, the individual joints may all be patent (not fused).
  • When those joints are patent, it means that there can be movement at those joints.
  • The movement of those joints could be either normal or abnormal, depending on how sturdy the ligaments are.
  • Ligaments attach one bone to the next bone. If the ligaments are torn, stretched, or loose, then there can be excessive movement at the joint (also called hyper mobility or instability).
  • The best way to assess for hypermobility is by doing sitting versus standing x-rays and comparing the position of the tailbone while someone is standing compared with while they are sitting. You can read more about sit-stand coccyx x-rays here at this link.
A Coccyx where SOME Joints are Fused and SOME Joints are Patent
  • Many people have some of their coccygeal bones fused together, while some of their other joints at the coccyx are not fused.
  • The take home message is that this varies from patient to patient.
  • It is important to CORRELATE the imaging findings with the exact site of the patient’s pain.
To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

UK Sitting-Standing Coccyx X-rays for Tailbone Pain, Coccydynia

I have a great update regarding getting coccyx x-rays done in the United Kingdom.

I have previously reported that in the UK, the National Health Service (NHS) has radiology protocols that explicitly deny the usefulness of tailbone x-rays (coccyx radiographs, xrays) for patients suffering with tailbone pain (coccyx pain, coccydynia). See Link:
Wrong-Minded Denials of Coccyx X-rays by the UK Radiology Directorate, NHS Foundation Trust

Detective Work on Getting Coccyx X-rays in the UK
  • Fortunately, someone with tailbone pain in the UK looked into this further and shared the following information with me. They do not want to be named or given public credit, so I will of course respect their privacy. But I do acknowledge and greatly appreciate their efforts and the information they provided, which is below.
  • They tracked down the Royal College of Radiologists (RCR) latest national guidelines, called iRefer. “They list conditions and recommended imaging, with comments. These form the basis of Trust guidelines.”
  • “So I spent £30 on the latest set of iRefer RCR guidelines…. Lo and behold, as of December 2017, they do recommend sit/stand x-rays in intractable cases (SEE PHOTO). They mention that these need to be done at specialist centres. We need to find out where these centres are – ask your local spinal surgeon about this. Your GP [general practicioner] is unlikely to know as it is a specialist investigation. I suspect that the message has not trickled down to all radiology departments… and guidelines at most Trusts haven’t been updated yet.”
Summary on UK coccyx x-rays:
  • Good News: In the UK, the Royal College of Radiologists does have guidelines (from year 2017) that do indeed recommend sit/stand x-rays of the coccyx in intractable cases of coccyx pain.
  • Bad News: In the UK (and much of the world), you still may have a challenging time finding a radiology center that knows how to properly perform and interpret the sitting-versus-standing xrays.
  • Those in the UK suffering from coccyx pain should share this Royal College of Radiologists iRefer guidelines with their treating doctors.
Photos of the Royal College of Radiologists iRefer guidelines book, section on coccyx x-rays for tailbone pain:
Royal College of Radiologists, RCR, iRefer, Guidelines

Royal College of Radiologists, RCR, iRefer, Guidelines

Sit-Stand-Coccyx-Xrays, supported by UK criteria from the Royal College of Radiologists, RCR, iRefer, Guidelines

Sit-Stand-Coccyx-Xrays, supported by UK criteria from the Royal College of Radiologists, RCR, iRefer, Guidelines

Sit-Stand-Coccyx-Xrays, supported via UK criteria from the Royal College of Radiologists, RCR, iRefer, Guidelines

Sit-Stand-Coccyx-Xrays, supported via UK criteria from the Royal College of Radiologists, RCR, iRefer, Guidelines

To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

How to improve surgical outcomes when coccygectomy is done for coccydynia, coccyx pain, tailbone pain.

Here’s an idea to help improve surgical outcomes when coccygectomy is done for coccydynia, coccyx pain, tailbone pain:
Intraoperative X-rays During Coccygectomy, To Improve Surgical Outcomes for Coccydynia, Coccyx Pain, Tailbone Pain
  • I wrote this up and submitted it to a medical journal called “Pediatric Surgery International” and they published it this past week.
  • Over the past 20 years, many patients have come to see me due to persistent coccyx pain after coccygectomy (surgical amputation of the coccyx).
  • In many cases, we find that the surgeon accidentally left fragments of the coccyx behind. Depending on the location, these can be painful.
  • In other cases, the primary site of the coccyx problem was never removed by the surgery.So the pain persists.
  • These problems happen mainly because the surgeon has only a limited view through a small incision during this surgery into a small area.
  • My proposed solution is for surgeons to take x-rays immediately before starting the surgery and before ending the surgery. This way, the surgeons could be more confident about whether they removed all of the bones that they wanted to remove. The x-rays would also show if the surgeons left a sharp or pointy edge at the site where they cut through the bone. (This is important since a sharp, pointy edge can cause pain when you sit on it.)
  • I brought this up in the context of a case where x-rays were used during removal of a cancer in the coccyx region. My proposal is that this approach should also be used for coccydynia patients who do not have cancer.
  • I am very happy that this international surgery journal has published this.
  • I hope that surgeons will read this and start to follow this recommendation.
  • I think this can decrease the number of coccygectomy patients who have a bad and painful outcome.
Dr Foye's Letter- X-rays during coccygectomy for coccyx pain, tailbone pain

Dr Foye’s Letter- X-rays during coccygectomy for coccyx pain, tailbone pain

PubMed - X-rays during coccygectomy for coccyx pain, tailbone pain

PubMed – X-rays during coccygectomy for coccyx pain, tailbone pain

Pediatric Surgery International, Journal Cover

Pediatric Surgery International, Journal Cover

To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

MRI of Broken Tailbone, Coccyx Fracture. See what the Radiologist missed!

MRI Tips on How To See a Broken Tailbone, Coccyx Fracture.
You Can See what the Radiologist Missed!
  • Patrick Foye, M.D. discusses MRI (Magnetic Resonance Imaging) showing of a Broken Coccyx, or Tailbone Fracture.
  • MRI shows a Fractured Coccyx.
  • Radiologists often FAIL to see these abnormalities!
The actual VIDEO is at the bottom of this page.
Here is the TEXT from the video:
  • Okay. This is just a short video showing a fracture of the tailbone, a coccyx fracture or tailbone fracture or a broken tailbone, broken coccyx, however you want to say it.
  • This is a coccyx injury that has resulted in a bony fracture at the tailbone.
  • I am Dr. Patrick Foye.
  • I am Director of the Coccyx Pain Center here in New Jersey.
  • And my website is www.TailboneDoctor.com.
  • Just a quick F.Y.I., these videos are meant of course purely for educational purposes, they are not to be considered medical advice or medical care.  For that you should see a physician with experience in treating tailbone injuries and tailbone pain.
  • So getting back to this here, what I am looking at is an MRI study.
  • And just to get people oriented for starters, I am just going to move this kind of front and center here and what you’ll see is that an MRI study typically includes lots of different ways that the images are taken, lots of different slices from different angles and with different emphasis on what the signals are showing as far as how water and other content shows up on the images.
  • So here you can see many different ones.
  • Now if I click the mouse over these you’ll see that as you hover for a moment it will show you this is a “T2″ image, it’s also a “sagittal” image.
  • As I hover over the next one here for a moment it’ll show you that that’s a “T1 sagittal” image.
  • So if you can see that on the image as each one shows up, these are axial images T1 and T2 axial images.
  • Some of these are more up at the lumbar spine, like this one that I have the cursor (or arrow) on now.
  • Whereas this one here does extend down through the sacrum and coccyx.
  • The point being: there are hundreds and hundreds and hundreds of images in a thorough MRI study.
  • And sometimes it will only be one or two images that show the actual pathology that’s occurring at the tailbone.
  • So it’s very important that the evaluating physician look through the images carefully to look at the site where the person is actually having the pain, to make sure that the tailbone is included in the images and then to look and see whether it looks normal or abnormal.
  • What I’m going to do now is just to move this overview out of the way and I’ll show you some of the images that I’ve pulled up here, again just for educational purposes.
  • So it’s called a T1 sagittal image.
  • Sagittal images: you can think of slices being done from left to right.
  • So if a slice went right down the midline of the patient separating them into a right half and a left half, that would be a sagittal image.
  • And that’s what you can see here in this particular image.
  • Here up at this level would be, where my pointer is here, that would be up at the lumbar spine.
  • So up around the beltline and then down through here is the sacrum and the coccyx is down below that.
  • And one of the things we can see: typically the sacrum (usually not always, but usually) has five sacral segments.
  • So I’ll count those off here: segments one, two, three, four and five.
  • And what that means is that this dark line here is the sacral coccygeal joint, where the sacrum meets the coccyx.
  • And then down below that are the coccygeal bony segments: one, two, three, four that we can see in this particular slice or image here.
  • So where does that leave us?
  • Well, I have this pulled up for you already, typically you would have needed to scroll through perhaps hundreds of images to get to this image, but for efficiency on the video I’ve already pulled it up here.
  • And the main thing that should stand out to you is if you look at this first bony segment of the coccyx here, you can see that that sort of dark line going through it.
  • So instead of looking like a rectangle that has a similar shading or intensity throughout the entire bony segment and looking similar to the vertebral bony segments up here and the sacrum and the ones down here in the lower coccyx, this one right here you can clearly tell is abnormal in its appearance.
  • So that’s point number one.
  • And the reason it’s abnormal in this particular patient is that there is a fracture of this first bony segment of the coccyx.
  • Now one of the things you can also do in terms of looking at how recent that fracture may be, is also looking on other images such as T2 images or STIR images.
  • And I have over here some what are called STIR images which help to have fluid show up brightly.
  • And here what you can see is this same slice (because these if I scroll through these you’ll see that both of the images scroll through together and also you can see how you would be scrolling through image after image and you need to get to the right image or two, to show the pathology). And by looking here at the image on the left side of the screen, you can see right here where the abnormality comes into play, it matches up right here where there’s brightness within that particular segment of the coccyx.
  • The reason for that brightness is because there is fluid content, extra fluid content at the site of the coccyx fracture.
  • So again this is just a quick view of a couple of images on an MRI showing a tailbone fracture and the images here at the right showing that that fracture is relatively recent or at least that there’s ongoing inflammation at that fracture site.
  • So I hope that this is helpful in terms of evaluation of the sacrum and coccyx in particular on MRI studies when looking for a coccyx fracture.
  • For more information please go to the website www.TailboneDoctor.com.
  • Thank you.
Here is the actual VIDEO:

Here is the screenshot thumbnail image for the video:
MRI of a Broken Tailbone, Coccyx Fracture, Coccyx Pain, Tailbone Pain, Coccydynia

MRI of a Broken Tailbone, Coccyx Fracture, Coccyx Pain, Tailbone Pain, Coccydynia

To get your copy of the book “Tailbone Pain Relief Now!” go to: www.TailboneBook.com
For more information on coccyx pain, or to be evaluated at Dr. Foye’s Tailbone Pain Center in the United States, go to: www.TailboneDoctor.com

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