Coccygodynia Differential Diagnoses

Updated: Feb 08, 2017
  • Author: Deepak Gautam, MBBS, MS; Chief Editor: Jeffrey A Goldstein, MD  more...
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DDx

Diagnostic Considerations

The differential diagnosis can be broadly divided into the the following three major categories:

  • Nociceptive
  • Neuropathic
  • Visceral

The nociceptive aspect of the differential diagnosis includes conditions involving pain arising from the os coccygis, [17]  such as the following:

  • Levator ani syndrome, where the mobilization of the os coccygis is not painful
  • Osteomyelitis
  • Intraossal lipoma
  • Intraossal chondroma
  • Avascular necrosis
  • Precoccygeal cysts
  • Degenerative disease

The neuropathic aspect includes conditions in which the pain arises from the spine, [18]  such as the following:

  • Lumbar disc herniation, where the symptoms are not related to provocation by sitting
  • Neural tumors (eg, schwannoma, neurinoma, chordoma, arachnoid cysts of the cauda equina, sacrococcygeal meningeal cysts, and paragangliomas of the caudal end of the os coccygis)

Visceral pain is the result of pain referred from the visceral structures [19]  and may arise from the following:

  • Infections and tumors of the rectum, sigmoid colon. and urogenital system
  • Metastases