Tailbone X-rays: Coned-in View for Coccyx Pain

It can be challenging to get to the correct x-rays done in the medical testing for someone with tailbone pain (coccyx pain).

  • Unfortunately, it is VERY common that the x-rays fail to focus on the area of pain (the coccyx).
  • Unfortunately, the tailbone x-rays include LOTS of other nearby anatomic regions, such as:
    • the thigh bones (femurs),
    • the hip joints at the middle of the pelvis,
    • the pubic bones at the front of the pelvis,
    • the lumbosacral spine at the lower back (the “small” of the back, up around the belt line).
  • In general, because of all of those structures are MUCH bigger than the coccyx the images tend to be washed out at the coccyx.
  • I often compare this to trying to take a photograph of my pinky fingernail.
    • Bad: If you took the photograph of my pinky fingernail with me holding my pinky in front of a bright window on a sunny day, the camera would adjust for the brightness outside that fills most of the photo. This would leave my pinky looking very washed out in the photo. This would make it difficult to see any significant details.
    • Good: Alternatively, if you took the photograph of my pinky fingernail by having the camera zoom in on just the structure that you are interested in (my fingernail) then you would get a nice, clear and detailed image of the structure that you are interested in.
  • Your ordering physician can specifically request that the tailbone x-rays be done using a “coned-in” technique
    • sometimes also called a “coned-down” technique
    • sometimes also called x-ray “collimation.”
  • Better and safer: In addition to providing a more clear and detailed image of the tailbone, the coned-in technique helps to decrease the amount of unnecessary radiation delivered to the patient.

Please post your thoughts, feedback, comments or questions below, regarding coned-in xrays for tailbone pain.

Patrick Foye, M.D.

Founder and Director at The Tailbone Pain Center
Patrick Foye, M.D.
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