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Man Falls on Buttocks

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There are degenerative changes present. Bilateral hip prostheses are noted. Within the coccyx, there is bone remodeling and angulation that are likely chronic and related to remote trauma or injury (arrow). Below this, some cortical lucency (circled) is noted, most likely consistent with an acute fracture. The patient was prescribed a nonsteroidal medication and a mild narcotic pain medication. 

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Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

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Clinician Reviews - 24(8)
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13,22
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Radiology review, buttocks, fall, coccyx, sacrum, degenerative changes, hip prostheses, trauma, cortical lucency, fracture
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Author and Disclosure Information

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

Author and Disclosure Information

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

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ANSWER
There are degenerative changes present. Bilateral hip prostheses are noted. Within the coccyx, there is bone remodeling and angulation that are likely chronic and related to remote trauma or injury (arrow). Below this, some cortical lucency (circled) is noted, most likely consistent with an acute fracture. The patient was prescribed a nonsteroidal medication and a mild narcotic pain medication. 

ANSWER
There are degenerative changes present. Bilateral hip prostheses are noted. Within the coccyx, there is bone remodeling and angulation that are likely chronic and related to remote trauma or injury (arrow). Below this, some cortical lucency (circled) is noted, most likely consistent with an acute fracture. The patient was prescribed a nonsteroidal medication and a mild narcotic pain medication. 

References

References

Issue
Clinician Reviews - 24(8)
Issue
Clinician Reviews - 24(8)
Page Number
13,22
Page Number
13,22
Publications
Publications
Topics
Article Type
Display Headline
Man Falls on Buttocks
Display Headline
Man Falls on Buttocks
Legacy Keywords
Radiology review, buttocks, fall, coccyx, sacrum, degenerative changes, hip prostheses, trauma, cortical lucency, fracture
Legacy Keywords
Radiology review, buttocks, fall, coccyx, sacrum, degenerative changes, hip prostheses, trauma, cortical lucency, fracture
Sections
Questionnaire Body

A 75-year-old man presents to the urgent care center for evaluation of pain in his buttocks after a fall. He states he was walking when his “legs gave out” and he hit the ground. He landed squarely on his buttocks, causing immediate pain. He was eventually able to get up with some assistance. He denies any current weakness or any bowel or bladder complaints. His medical/surgical history is significant for coronary artery disease, hypertension, and bilateral hip replacements. Physical exam reveals an elderly male who is uncomfortable but in no obvious distress. His vital signs are stable. He has moderate point tenderness over his sacrum but is able to move all his extremities well, with normal strength. Radiograph of his sacrum/coccyx is shown. What is your impression?
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