Initial imaging for coccyx pain is plain radiography—lateral coccyx X‑ray, often with sitting/standing or dynamic views to detect fractures, subluxation, or instability. If pain persists or red flags exist, MRI is preferred to assess bone marrow edema, soft tissues, infection, or neoplasm. CT is useful for complex fractures or preoperative planning.

A coccyx MRI typically takes about 20–40 minutes of scanning. If contrast (gadolinium) is needed, add roughly 10–20 minutes for injection and extra sequences. Allow extra time for registration, safety screening and positioning, so the full appointment usually lasts 30–60 minutes. Times vary with scanner type and specific protocols; follow any local instructions about arrival and metal removal.

On MRI, coccydynia often shows bone marrow edema within the coccyx, increased T2/STIR signal and contrast enhancement of adjacent soft tissues and joints, degenerative changes or subluxation at sacrococcygeal/intercoccygeal joints, occult fracture lines, and surrounding soft‑tissue swelling. Findings may include joint effusion, ligament tears or hypertrophy, and post‑traumatic alignment abnormalities, helping distinguish inflammatory versus mechanical causes.

There are four coccyx types (Postacchini classification): Type I — nearly straight or slightly curved forward; Type II — more noticeably curved anteriorly; Type III — sharply angulated forward at one or more levels; Type IV — subluxated or dislocated segments (marked instability, often with anterior or posterior displacement). Morphology affects pain risk and treatment decisions.

Start with your GP or family doctor for coccyx pain — they’ll assess causes, provide analgesics and refer if needed. Referrals often go to an orthopedic or spine specialist, pain-management physician (for injections or nerve blocks), and physiotherapist or pelvic-floor specialist. If pain began after childbirth, see an obstetric/urogynecology team; for severe injury, neurological signs, or incontinence seek emergency care promptly.

Costs vary by country and setting. In India a coccyx X‑ray typically costs about ₹300–₹1,000. In the UK it’s free on the NHS but private scans usually run £50–£200. In the US retail prices vary widely, roughly $50–$300 (often higher if done in hospital or billed through insurance). Final price depends on location, facility type and extra views or reporting.