What it is (overview)

An XR Coccyx 2+ views is a diagnostic imaging test that uses X-ray technology to take two or more images of the coccyx (tailbone) from different angles. The coccyx is the small set of bones at the very bottom of the spine, just below the sacrum, and it can be injured during a fall, childbirth, or other pelvic injury.

This test does not “measure” a lab value like bloodwork. Instead, it creates pictures of the tailbone and nearby joints to look for:

• Fractures (cracks or breaks in the bone)
• Dislocations or misalignment (the coccyx shifted out of its normal position)
• Abnormal shape or alignment that may contribute to tailbone pain (often called coccydynia)
• Less commonly, signs of infection, arthritis, or tumors involving the bone

What results can mean: A “normal” result usually means the coccyx bones and alignment look typical with no obvious break or displacement. An “abnormal” result may show a tailbone fracture, a dislocation, or changes that suggest inflammation or degenerative joint disease. It’s also possible to have significant tailbone pain with an X-ray that looks normal, because some causes (such as ligament injury, muscle spasm, nerve irritation, or subtle soft-tissue problems) may not be visible on standard X-ray. Your clinician will interpret the images along with your symptoms and physical exam as part of an overall health assessment.

When & why it's usually done

Doctors commonly order an XR Coccyx (2+ views) when someone has tailbone or lower spine symptoms—especially after an injury—and the goal is to quickly evaluate for a fracture, dislocation, or other structural problem.

This test is often performed for:

• Tailbone pain (coccydynia) that is persistent, severe, or worsens with sitting, rising from sitting, or bowel movements
• Recent trauma such as a fall onto the buttocks, sports injury, or impact during an accident
• Suspected pelvic or lower back injury with localized tenderness at the tailbone
• Postpartum tailbone pain, especially after difficult or prolonged labor (sometimes related to coccyx strain or displacement)
• New pain with swelling, redness, drainage, fever, or unexplained weight loss (to help assess for less common but important causes such as infection or malignancy)

Multiple views are requested because a single angle may miss subtle misalignment or a small fracture. If symptoms persist despite a normal X-ray, your clinician may consider additional imaging (such as MRI or CT) to evaluate soft tissues, nerves, or complex bone detail.

Common diseases related to it

• Coccyx (tailbone) fracture
• Coccygeal dislocation or subluxation
• Coccydynia (chronic tailbone pain)
• Degenerative joint disease/osteoarthritis affecting the sacrococcygeal region
• Sacrococcygeal sprain/ligament injury (may be suspected even if X-ray is normal)
• Pilonidal disease near the tailbone region (may prompt evaluation when pain is present, though it is primarily a skin/soft-tissue condition)
• Bone infection (osteomyelitis) of the coccyx (less common)
• Bone tumors or metastatic lesions involving the coccyx (rare)

Health goals where it may help

• Identify the cause of tailbone pain to guide effective treatment (rest, cushions, physical therapy, medication, injections, or referral)
• Assess injury severity after a fall or pelvic trauma and plan safe return to activity
• Rule out fracture or dislocation in persistent lower back/pelvic pain focused at the coccyx
• Support an overall musculoskeletal health assessment when symptoms affect sitting, walking, or daily function
• Monitor healing or alignment when symptoms continue after treatment or a known injury