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The overlooked symptom of coccydynia: evaluation of sacrococcygeal morphologic and morphometric findings

Das übersehene Symptom der Kokzygodynie: Beurteilung sakrokokzygealer morphologischer und morphometrischer Befunde

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Abstract

Background

Coccydynia is one of the most overlooked symptoms in daily clinical practice. Definitions for radiologic evaluation are controversial.

Objectives

We aimed to compare the morphology and morphometric measurements of the sacrococcygeal region with those of a healthy population to support radiologic decision-making.

Materials and methods

In total, 26 traumatic and 50 idiopathic cases of coccydynia as well as 74 healthy control cases were retrospectively compared. The morphologic type of the coccyx, the presence of fusion, and the number of coccygeal segments were evaluated in both groups. Morphometric parameters such as sacrococcygeal angle (SCA), sacrococcygeal joint angle (SCJA), intercoccygeal angle (ICA), sacral slope (SS), coccyx curved length (CCL), sacrum curved length (SCL), coccyx length (CL), sacrum length (SL), and sacrococcygeal total length (SCTL) were investigated.

Results

Significant differences were found between the coccydynia group and the healthy control group in morphologic parameters such as female gender, coccyx segment, coccyx morphology, presence of sacrococcygeal joint, and segment of sacrococcygeal joint fusion (p < 0.05). In morphologic measurements, SCJA, SCL, SL, coccyx and sacrum curvature indexes were significantly increased (p < 0.05). No significant difference was found in the morphologic and morphometric parameters evaluated when compared with the duration of coccydynia (p > 0.05).

Conclusion

An increase in the SCJA, SCL, SL, SCI, and coccyx curvature index measurements predisposes to coccydynia. It would be more accurate to perform radiological evaluation by familiarization with these morphologic and morphometric parameters.

Zusammenfassung

Hintergrund

Die Kokzygodynie ist eines der am häufigsten übersehenen Symptome im klinischen Alltag. Und die Definitionen zur radiologischen Beurteilung sind umstritten.

Ziel

Ziel der vorliegenden Arbeit war es, die erhobenen morphologischen und morphometrischen Messungen der sakrokokzygealen Region mit jenen einer gesunden Population zu vergleichen, um zur radiologischen Entscheidungsfindung beizutragen.

Material und Methoden

Retrospektiv wurden 26 traumatisch bedingte und 50 idiopathische Fälle von Kokzygodynie sowie 74 Fälle gesunder Kontrollen verglichen. Dabei wurden in beiden Gruppen der morphologische Typ des Steißbeins, das Vorliegen einer Fusion und die Anzahl der Steißbeinsegmente untersucht. Morphometrische Parameter wie sakrokokzygealer Winkel (SCA), Sakrokokzygealgelenkwinkel (SCJA), interkokzygealer Winkel (ICA), Neigung des Kreuzbeins (SS), gebogene Länge des Steißbeins (CCL), gebogene Länge des Kreuzbeins (SCL), Steißbeinlänge (CL), Kreuzbeinlänge (SL) und sakrokokzygeale Gesamtlänge (SCTL) wurden bestimmt.

Ergebnisse

Zwischen der Gruppe mit Kokzygodynie und der gesunden Kontrollgruppe fanden sich wesentliche Unterschiede bei morphologischen Parametern wie weiblichem Geschlecht, Steißbeinsegmenten, Steißbeinmorphologie, Vorliegen eines Sakrokokzygealgelenks und Segmenten der Sakrokokzygealgelenkfusion (p < 0,05). Bei den morphologischen Messungen waren die Indexwerte für SCJA, SCL, SL, Steißbein- und Kreuzbeinkrümmung signifikant erhöht (p < 0,05). Dagegen war kein signifikanter Unterschied für die morphologischen und morphometrischen Parameter beim Vergleich in Bezug auf die Dauer der Kokzygodynie festzustellen (p > 0,05).

Schlussfolgerung

Eine Zunahme der Indexwerte für SCJA, SCL, SL, SCI und Steißbeinkrümmung prädisponiert zur Kokzygodynie. Die radiologische Beurteilung könnte genauer werden, indem die Untersucher sich mit diesen morphologischen und morphometrischen Parametern vertraut machen.

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Authors and Affiliations

  1. Department of Radiology, Başkent University Alanya Research and Application Center, Yunus Emre Cd. No:1, 07400, Alanya/Antalya, Turkey

    Abdullah Sukun MD

  2. Department of Radiology, Başkent University Ankara Hospital, Ankara, Turkey

    Hazal Selvi Cubuk MD, Tijen Cankurtaran MD, Büsra Yavuz Sarsam MD & Burak Yagdiran MD

  3. Department of Biostatistics, Başkent University, Ankara, Turkey

    Caner İncekas

Authors
  1. Abdullah Sukun MD
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  2. Hazal Selvi Cubuk MD
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  3. Tijen Cankurtaran MD
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  4. Büsra Yavuz Sarsam MD
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  5. Burak Yagdiran MD
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  6. Caner İncekas
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Contributions

Study conception and design: Abdullah Sukun; Data collection: Hazal Selvi Cubuk, Tijen Cankurtaran, Büsra Yavuz Sarsam, Burak Yagdiran; Analysis and interpretation of results: Caner Incekas; Draft manuscript preparation: Abdullah Sukun. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Abdullah Sukun MD.

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Conflict of interest

A. Sukun, H.S. Cubuk, T. Cankurtaran, B.Y. Sarsam, B. Yagdiran and C. İncekas declare that they have no conflicts of interest.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

The supplement containing this article is not sponsored by industry.

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Data availability statement

The data that support the findings of this study are not openly available due to reasons of patient privacy and are available from the corresponding author upon reasonable request.

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Sukun, A., Cubuk, H.S., Cankurtaran, T. et al. The overlooked symptom of coccydynia: evaluation of sacrococcygeal morphologic and morphometric findings. Radiologie 63 (Suppl 2), 113–122 (2023). https://doi.org/10.1007/s00117-023-01239-z

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  • DOI: https://doi.org/10.1007/s00117-023-01239-z

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