Bursal cyst (bursitis) of the coccygeal region clinically mimics sacrococcygeal meningocele.
METHODS
Bursal cysts (bursitis) are attributed to repeated microtrauma of the connective tissue around the synovial joint and are rare in the coccygeal region.


METHODS
A 10-year-old boy had a subcutaneous tumor at the midline of the buttock. He could not walk and slid himself in a seated position because of psychomotor retardation. MR images showed a cystic lesion overlying the coccygeal bone, the intensity of which was identical to cerebrospinal fluid (CSF). Although meningocele was suspected, constructive interference in steady-state (CISS) MR images clearly depicted a discontinuity between the cyst and CSF space.


CONCLUSIONS
It was conceivable that repeated friction between the coccygeal bone, which projected posteriorly, and overlying subcutaneous tissue during movement resulted in the formation of a bursal cyst. In addition to total removal of the cyst, the coccygeal bone was planed away to prevent friction. We should keep this rare clinical entity in mind in cases that appear to be sacrococcygeal meningocele.
Samura
Kazuhiro
K
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Morioka
Takato
T
Hashiguchi
Kimiaki
K
Yoshida
Fumiaki
F
Hokama
Masaaki
M
Yamaguchi
Shinya
S
Nagata
Shinji
S
Suzuki
Satoshi O
SO
Yoshiura
Takashi
T
Sasaki
Tomio
T
D002062:Bursitis / Q000473:pathology*; D002648:Child; D003560:Cysts / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele / Q000175:diagnosis*; D012445:Sacrococcygeal Region / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods