Sacral Rheumatoid Nodule: An Unusual Indication for Coccygectomy

Abstract

Here, we present a case report of a woman who presented with a large sacral rheumatoid nodule. This patient failed conservative treatment and presented in search of a surgical solution. We successfully removed her rheumatoid nodule using a surgical approach typically reserved for traumatic coccydynia. We show how coccygectomy, although a rare surgical procedure, was effective in treatment of a large rheumatoid nodule.

An Unusual and Rare Location of Intra-articular Rheumatoid Nodule in the Elbow Joint - A Case Report

“…Patients with intra-articular RNs are usually symptomatic with joint pain and restricted mobility, similar to this case, and excisions were done in most of these cases. One of seven cases of intra-articular RNs in the knee joint and one of two cases in the sacrococcygeal joint showed recurrence, and no recurrences were reported in the ankle and wrist joints [5][6][7][8]. On regular follow-up after six months, the patient's symptoms improved with the restoration of joint mobility and reduction in joint pain with no signs of infection or recurrence.…”

“…However, intra-articular rheumatoid nodules are exceptionally rare. Rare cases of intra-articular rheumatoid nodules in the knee joint, wrist joint, ankle joint, and sacrococcygeal joint are reported [5][6][7][8].…”

Imaging findings and treatment in coccydynia – update of the recent study findings

“…A rectal duplication cyst can also cause pain in the coccygeal region [17]. The etiology of non-idiopathic coccydynia may include carcinoid tumors, sacrococcygeal teratomas, sacral giant cell tumors, epithelial cysts, dermoid cysts, and nodular rheumatoid arthritis [18,19]. Coccydynia caused by lesions and diseases developing around the coccyx is portrayed in ▶ Fig.…”