Pants' Zippers Blocking View of the Coccyx on X-rays

Pants’ Zippers Blocking View of the Coccyx on Tailbone X-rays
  • Many radiology imaging centers have no idea how to properly perform x-rays of the coccyx for people who have tailbone pain (also called coccyx pain or coccydynia).
  • Sometimes even the most basic problems occur.
  • I have seen many, many patients over the years where the prior x-rays were done in such a way that the tailbone could not be seen at all.
  • Sometimes the imaging studies do not include the coccyx because the images are of the wrong body region.
  • Sometimes, like in this example, the images are done of the correct body region, but the patient is wearing denim jeans or other pants with a zipper that completely blocks the view of the coccyx on the frontal view (also called the A-P, or anterior-posterior, view).
  • This could have been easily avoided by having the patient change into a gown, or shorts without a zipper, before the x-rays were taken.
  • Instead, these patients undergo poorly done testing.
  • Not only does this waste time and money by doing a test that gives no useful information. Even worse is that often the treating doctor fails to look at the images themselves, so they don’t even realize there was a problem. Then, the patient is just told that their coccyx x-rays did not reveal any coccyx abnormalities. But, in fact, the coccyx x-rays failed to even adequately show the coccyx!
  • This may sound crazy that these things would happen. But patients traveling to see me from all around the country and it is unfortunately VERY common that the previous imaging studies have these kinds of problems. I discover these kinds of problems in my patients’ prior imaging studies essentially everyday.
Here is the video:

Here is the screenshot image from the video:

Pants Zipper Blocks View of the Coccyx, Tailbone, on Xrays

Pants Zipper Blocks View of the Coccyx, Tailbone, on X-rays

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Text transcribed from the video above:
  • This video is about zippers on your pants that can be blocking the view of the coccyx on x-rays.
  • So for people with tailbone pain, if they have an x-ray done of the coccyx, they can have zippers on their pants that can get in the way of the x-rays (which could happen if they are not changed into a gown to have the x-rays taken).
  • I’m Dr. Patrick Foye.
  • I’m the Director of the Coccyx Pain Center here in the United States.
  • I’m online at
  • And I’ve been treating people with tailbone pain for over 20 years.
  • I’ve treated thousands of patients.
  • And unfortunately from time to time there will be somebody who comes in and they bring their x-rays with them that they had done previously at an outside institution… and we’ll take a look at the x-rays, take a look to see if they show the coccyx or tailbone.
  • And what happens is what happened here, which is the tailbone is hidden behind the zipper of the patient’s pants.
  • So, this is a view of the pelvis right here.
  • So I don’t know if this will show up, I’m kind of in a dark room at the moment, but I’m holding up an anatomic model of the pelvis and at the back of the pelvis you can see the sacrum and coccyx there.
  • But on this x-ray, here’s our pelvis, the sacrum is back here, the coccyx would be hidden right behind the zipper.
  • It’s also in this case hidden behind the pubic bone but for purposes of this x-ray and the point of this video, even if the image was appropriately tilted to show the coccyx the zipper would still be blocking the view of the coccyx.
  • And it’s really a shame because people have tailbone pain and they suffer for months and years often without an accurate diagnosis.
  • And one of the reasons why they suffer for years without an accurate diagnosis is because so many places do the wrong imaging studies or do the imaging studies the wrong way.
  • So in this patient again the exact area that the study was being done for (which was tailbone pain) the tailbone is hidden behind the zipper of the person’s pants.
  • And here’s the buckle or the button or rivet or whatever just above the zipper at the front of the person’s pants.
  • And you can see some of the other rivets here and here from the side pockets of the pants.
  • So again this could be very easily fixed by just having a patient change into a gown, or into a pair of shorts even that does not have any buttons or zippers in the patient’s clothing.
  • And especially that if it did have buttons or zippers that you do the imaging studies in such a way that it’s not blocking the area that you are most interested in for that patient.
  • So that’s the general take-home message.
  • The other thing that can be done of course is to do the x-ray from the side.
  • So that instead of only taking the x-ray from that front view (where you can see right now the pubic bone is blocking the view now the tailbone comes in but if the zipper was there it would still be blocked) but the other thing you can do is to take the image from the side which is more aligned kind of like this which is called a lateral view in medical lingo.
  • So those are a couple of points about the x-rays of the coccyx and avoiding having a zipper get in the way of the coccyx or tailbone on your x-rays.
  • For more information, you can find me online at or on Twitter @TailboneDoctor.
  • And if you have questions about this, you can post them down below this video.
Patrick Foye, M.D.
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