1. Sacrum/Coccyx and SI Jnts.
Review RPO/LPO positioning

2. Routine Views:
Sacrum/Coccyx
AP axial
Lateral

3. AP Axial Sacrum

4. Structures Shown
The entire sacrum free of superimposition

5. Good film: The pubic bones should not overlap the sacrum
No foreshortening (angle 15 degrees up)
Good even contrast
No rotation
Sacrum centered to film
Good collimation
Fecal material should not overlap the sacrum

6. AP Axial coccyx

7. Here is a list of some of physical traumas that tailbone sufferers have experienced and reported from Tailbone.com:
Auto Accident, rear-end collision Auto Accident, vertical fall from a cliff Child birth (vaginal) delivery Dead-lifting of heavy weights or barbells Fall on the buttocks down the stairs or ladders Fall on the buttocks during Cheerleading Stunts (Throw & catch or Pyramids) Fall on the buttocks during gymnastics on a balance beam Fall on the buttocks during ice skating Fall on the buttocks during roller blading or in-line skating Fall on the buttocks during roller skating Fall on the buttocks during skiing Fall on the buttocks during snow boarding Fall on the buttocks from a swing Fall on the buttocks in a bath tub Fall on the buttocks in a bathroom Fall on the buttocks on a frozen sidewalk Fall on the buttocks on a oily or greased floor Fall on the buttocks while skate boarding Horseback riding or falling from a horse Martial Art accidental contact with buttocks Prolonged sitting Sexual intercourse Sitting during Pregnancy Sitting on a bicycle seat with gel padding Sitting on a broken car seat or office chair Sitting on a thinly padded bicycle seat Sitting on hard surfaces such as stadium bleachers Slip and fall on a hard slippery/wet tile floor Sports injury, accidental kick in the buttocks Straddle injury on a fence top or tree limb Water slide drops and jumps

8. Structures Shown
The whole coccyx and distal sacrum free of superimposition

9. Good Film
The coccygeal segments should not be superimposed by pubic bones (angle)
Good even contrast
Coccyx should be centered to film and seen in its entirety
No rotation
Good collimation
Do they need to use the
restroom?

10. Lat. Sacrum/coccyx

11. Structures Shown
The lateral aspect of the entire sacrum and entire coccyx (**for L-S spine it is okay to clip coccyx)

12. Good Film:
The sacrum and coccyx should be seen clearly with even contrast
Good collimation
Superimposed iliac crest

13. SI joints
AP Axial ( same as up shot on L-S spine)
RPO/LPO

14. AP Axial SI joints
Same as AP axial for L-S spine Junction

15. RPO/LPO SI joints R L
LPO
RPO

16. Structures shown:
Shows the sacroiliac joint farthest from the IR and an oblique projection of the adjacent structures
**Always do both obliques for comparison

17. Good Film:
Open SI joint space with minimal overlapping of the ilium and sacrum
Joint centered on the film