The coccyx AP view is used to demonstrate the coccyx in conjunction with the sacrum and coccyx. The coccyx lateral view is used to demonstrate the attached point of spine in lateral position. Imaging of coccyx is difficult due to obstructing factors such as bowel, bladder and for patients who have difficulty to insert due to obesity.
While doing the imaging of sacrum and coccyx selectively, the amount of radiation dose is decreasing. Both, clean colon and an empty bladder can reduce the possibility of fluid which is blocking the view.
Before the procedure starts, the urinary bladder should be empty. Also, patient should clean the enema and gas in the colon as advised by the doctor. Remove your clothes and wear hospital gown. A thread in clothes may be the obstruction. If the AP sacrum and coccyx views are performed, there is a significant reduction in radiation exposure with no loss in diagnostic image. Doctors recommend the shielding of males but shielding of females is not possible. When the part is small, close alignment improves the detail. Technical factors: Image receptor size: 24 x 30 cm 10 x 12 inches film should be used (lengthwise), moving or stationary grid should be used.
The coccyx lateral view is used to show the most distal region of the spine in a lateral position. It is used in conjunction with the AP projection. It is used to show sacrum and coccyx anatomy, and to investigate the cause of sacral and coccyx pain in both acute and chronic conditions.
Patient and part conditioning should be proper. Patient face should be upwards. Pillow should be provided to him for head support and legs are extended. Pelvis should not be rotated. Central ray, collimation and respiration should be in proper condition.
Patient Positioning Factors: central ray alignment and correct coccyx shows coccyx free of superimposition and projected superior to pubis. Coccygeal segments can be fused if they didn’t appear open on radiograph. It should be noted that greater the curvature of the coccyx, the greater is the angulation needed. If the coccyx appears equal distant from lateral walls of the pelvic opening, it indicates there is no rotation of patient positioning is correct. Collimation, Central Ray and Exposure Factors: Sharp bone margins indicate that there is no motion of the body. The coccyx should be in the middle of collimated field.