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Patients were followed up until pain recurrence. Two radiologists assessed MRI findings prior to, and contrast distribution during CT injection. Imaging predictors for successful pain relief at 1 month (PPR\u2009\u2265\u200950%) combined with maintained pain relief for at least 3 months post-injection were investigated using logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      63 patients (mean age 44.6\u2009\u00b1\u200912.5 years) were evaluated. Average pain dropped from initially 6.3 to 3.0 (average PPR 53.2\u2009\u00b1\u200937.5%) 15\u2009min post-injection, and to 2.9 (average PPR 55.2\u2009\u00b1\u200941.4%) one month post-injection (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). One month post-injection, 41 patients (65%) reported PPR\u2009\u2265\u200950%. Pain relief persisted on average for 6 months. Three months post-injection, 32\/63 patients (50.8%) reported maintained pain relief. Fluid-sensitive sequence (FSS)-hyperintensity of the sacro-\/intercoccygeal synchondrosis, coccyx subluxation and a bony spicule were the only significant predictors (odds ratios: 3.5\u20135.1) of successful and maintained pain relief (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.031).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CT-guided pericoccygeal injection with ropivacaine and triamcinolone allowed successful pain relief in 65% of chronic coccydynia patients, with a PPR of 55% and persistence of 26 weeks on average. Odds of successful and maintained pain relief increased with the presence of a bony spicule, subluxation and FSS-hyperintensity of the synchondrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Imaging predictors of successful pain relief in chronic coccydynia patients receiving pericoccygeal ropivacaine and triamcinolone injections are unknown.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>A bony spicule, subluxation, and sacro-\/intercoccygeal fluid-sensitive sequence hyperintensity on MRI were significant predictors of successful pain relief for \u2265 3 months. CT-contrast distribution did not influence pain relief.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>CT-guided pericoccygeal injections with ropivacaine and triamcinolone offer successful pain relief in chronic coccydynia; the presence of a bony spicule, subluxation, and sacro-\/intercoccygeal fluid-sensitive sequence hyperintensity was predictive of pain relief.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12615-3","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:39:43Z","timestamp":1778690383000},"page":"7572-7583","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CT-guided injection in coccydynia: outcome prediction using MRI findings and CT-injection characteristics"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3814-7633","authenticated-orcid":false,"given":"Georg Wilhelm","family":"Kajdi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Marth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Germann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazda","family":"Farshad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto","family":"Sutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"12615_CR1","doi-asserted-by":"publisher","first-page":"299","DOI":"10.21037\/atm.2020.02.175","volume":"8","author":"A Wu","year":"2020","unstructured":"Wu A, March L, Zheng X et al (2020) Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. 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