From the Research
Sacrococcygeal junction lucency is typically a normal anatomical variant and usually requires no specific treatment, unless accompanied by symptoms such as coccydynia, in which case conservative management may be necessary. This finding represents a gap or radiolucent area at the junction between the sacrum and coccyx bones at the base of the spine. While it may sometimes be mistaken for a fracture, in most cases it simply reflects the natural articulation between these bones or incomplete fusion. No medications or interventions are typically needed. However, if the lucency is accompanied by pain in the tailbone area (coccydynia), conservative management including NSAIDs like ibuprofen (400-600mg three times daily with food), cushioned seating, and physical therapy may help, as suggested by a study on coccydynia treatment 1. The pain usually resolves within weeks to months. This lucency appears on X-rays because the fibrocartilaginous disc between the sacrum and coccyx allows some movement and appears less dense than surrounding bone.
Some studies have investigated the morphology and morphometric measurements of the sacrococcygeal region in patients with coccydynia, finding significant differences in parameters such as sacrococcygeal angle and coccyx curvature index compared to healthy controls 2. However, these findings do not necessarily imply a need for treatment of the lucency itself. Only in rare cases where there is significant trauma history, persistent severe pain, or other concerning features would additional imaging like MRI or CT be warranted to rule out pathologic conditions, as suggested by a study on the use of MRI in detecting sacrococcygeal fractures 3.
In general, the approach to sacrococcygeal junction lucency should prioritize a thorough clinical evaluation to determine the presence of any symptoms or underlying conditions that may require treatment, rather than relying solely on imaging findings. As noted in a study on sacroiliac joint dysfunction, a comprehensive understanding of the anatomy and pathophysiology of the region is essential for accurate diagnosis and management 4. Ultimately, the goal of treatment should be to alleviate symptoms and improve quality of life, rather than solely focusing on the lucency itself.