Differential Diagnosis for Tailbone Pain
Single most likely diagnosis
- Coccydynia: This condition is characterized by pain and tenderness in the tailbone area, often caused by a fall or trauma. The constant bruise-like pain and tenderness to the touch are consistent with coccydynia. The fact that sitting down is okay and nothing triggers the pain to get worse also supports this diagnosis.
Other Likely diagnoses
- Tailbone fracture: A fracture of the coccyx can cause persistent pain and tenderness, especially if the fracture is not properly aligned. The sudden onset of pain and tenderness to the touch are consistent with a fracture.
- Coccygeal bursitis: Inflammation of the bursa that cushions the tailbone can cause pain and tenderness in the area. The constant bruise-like pain and tenderness to the touch are consistent with bursitis.
- Pilonidal cyst: A pilonidal cyst is a type of skin infection that can cause pain and tenderness in the tailbone area. However, it is less likely given the absence of other symptoms such as swelling, redness, or discharge.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cauda equina syndrome: This is a rare but serious condition that occurs when the nerves in the spinal canal are compressed. It can cause pain, numbness, and weakness in the legs, as well as bowel and bladder dysfunction. Although the symptoms do not perfectly match, it is essential to consider this diagnosis due to its potential severity.
- Spinal infection: An infection of the spine, such as osteomyelitis or discitis, can cause pain and tenderness in the tailbone area. Although the symptoms do not suggest an infection, it is crucial to consider this diagnosis due to its potential severity.
Rare diagnoses
- Chordoma: A rare type of bone cancer that can occur in the tailbone area, causing pain and tenderness. Although it is unlikely, it is essential to consider this diagnosis due to its potential severity.
- Tarlov cyst: A rare condition characterized by the formation of a cyst in the nerve roots of the spine, which can cause pain and tenderness in the tailbone area. Although it is unlikely, it is essential to consider this diagnosis due to its potential impact on quality of life.