Differential Diagnosis for Coccyx Pain after Falling
- Single most likely diagnosis
- Coccydynia: This is the most common diagnosis for coccyx pain, especially after a fall. Coccydynia refers to pain in the coccyx (tailbone) area, often resulting from a direct blow to the coccyx, such as from a fall onto a hard surface. The pain can be acute or chronic and is usually exacerbated by sitting or direct pressure on the coccyx.
- Other Likely diagnoses
- Fracture of the coccyx: A fall can cause a fracture of the coccyx, leading to pain in the area. The severity of the pain and the presence of other symptoms like bruising or difficulty sitting can indicate the likelihood of a fracture.
- Soft tissue injury: The muscles, ligaments, and other soft tissues around the coccyx can be injured during a fall, leading to pain and discomfort in the area.
- Hematoma: A collection of blood outside of blood vessels (hematoma) in the soft tissues around the coccyx can occur after a fall, causing pain and swelling.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cauda equina syndrome: Although rare, this condition involves compression or damage to the nerves in the lower spine and can result from a severe injury, such as a fall. Symptoms include severe pain, numbness, and weakness in the legs, as well as bladder and bowel dysfunction. Early recognition and treatment are crucial to prevent permanent neurological damage.
- Infection (e.g., abscess): An infection in the area of the coccyx, such as an abscess, can cause significant pain and other systemic symptoms. While less common, missing an infection could lead to serious complications.
- Rare diagnoses
- Tarlov cysts: These are rare, fluid-filled sacs that can form on the nerve roots in the spine, including near the coccyx. They can cause pain, among other symptoms, but are relatively rare and often found incidentally.
- Chordoma: A rare type of bone cancer that can occur at the base of the spine, including the coccyx. While extremely rare, chordoma can cause pain and other symptoms, and early diagnosis is important for treatment.