Sacrum/Coccyx and SI Jnts.

Routine Views:

Sacrum/Coccyx AP axial Lateral

AP Axial Sacrum

Structures Shown

The entire sacrum free of superimposition

Good film:

The pubic bones should not overlap the sacrum

No foreshortening (angle 15 degrees up) Good even contrast No rotation Sacrum centered to film Good collimation Fecal material should not overlap the sacrum

AP Axial coccyx

Here is a list of some of physical traumas that tailbone sufferers have experienced and reported from Tailbone.com:

Auto Accident, rear-end collisionAuto Accident, vertical fall from a cliffChild birth (vaginal) deliveryDead-lifting of heavy weights or barbellsFall on the buttocks down the stairs or laddersFall on the buttocks during Cheerleading Stunts (Throw & catch or Pyramids) Fall on the buttocks during gymnastics on a balance beam Fall on the buttocks during ice skatingFall on the buttocks during roller blading or in-line skatingFall on the buttocks during roller skatingFall on the buttocks during skiingFall on the buttocks during snow boardingFall on the buttocks from a swingFall on the buttocks in a bath tubFall on the buttocks in a bathroomFall on the buttocks on a frozen sidewalkFall on the buttocks on a oily or greased floorFall on the buttocks while skate boardingHorseback riding or falling from a horseMartial Art accidental contact with buttocksProlonged sittingSexual intercourseSitting during PregnancySitting on a bicycle seat with gel paddingSitting on a broken car seat or office chairSitting on a thinly padded bicycle seatSitting on hard surfaces such as stadium bleachersSlip and fall on a hard slippery/wet tile floorSports injury, accidental kick in the buttocksStraddle injury on a fence top or tree limbWater slide drops and jumps

Structures Shown

The whole coccyx and distal sacrum free of superimposition

Good Film

The coccygeal segments should not be superimposed by pubic bones (angle)

Good even contrast Coccyx should be centered to film and seen

in its entirety No rotation Good collimation Do they need to use the

restroom?

Lat. Sacrum/coccyx

Structures Shown

The lateral aspect of the entire sacrum and entire coccyx (**for L-S spine it is okay to clip coccyx)

Good Film:

The sacrum and coccyx should be seen clearly with even contrast

Good collimation Superimposed iliac crest

SI joints

AP Axial ( same as up shot on L-S spine) RPO/LPO

AP Axial SI joints

Same as AP axial for L-S spine Junction

RPO/LPO SI joints

LR

RPOLPO

Structures shown:

Shows the sacroiliac joint farthest from the IR and an oblique projection of the adjacent structures

**Always do both obliques for comparison

Good Film:

Open SI joint space with minimal overlapping of the ilium and sacrum

Joint centered on the film