Coccydynia [KAH-kih-DYE-nee-UH] is pain in the tailbone, or coccyx [KAH-syks], that is usually the result of inflammation in the tailbone. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-31409, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":31409,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/coccydynia/questions/1609?lang=us"}. Most commonly just on one side, SI joint dysfunction is more common in young and middle-aged women. [2] Other ways that coccydynia develops are partial dislocation of the sacrococcygeal synchondrosis that can possibly result in abnormal movement of the coccyx from excessive sitting, and repetitive trauma of the surrounding ligaments and muscles, resulting in inflammation of tissues and pain. British volume. A possible but uncommon risk of coccygectomy is injury to the rectum as the coccyx is being removed. An additional benefit of aerobic activity is the release of endorphins, the bodys innate pain-relieving chemicals. Aetiology and treatment. Did surgical "Step" independently and comfortably without supervision. Normal Preoperative Images Do Not Indicate a Poor Outcome of Surgery for Coccydynia. Memorizing topics lays the foundation of knowledge needed to eventually apply knowledge and think critically. Accessibility MeSH If tailbone pain is persistent or severe, additional non-surgical treatment options for coccydynia may include: Injection. SKILL COMPLEXITY LEVEL: Our surgical Skills, are broken down into 5 levels of complexity and Roberts CS. What are the chances he will return to work within 6 weeks? Fogel GR, Cunningham PY, Esses SI. and see the relevance in clinical practive. Hence, the term coccydynia translates to coccyx pain. Watched surgical "Step" and partially invovled (held retractor). Her pain was exacerbated by any sitting whatsoever, particularly on the bike. 2020;40(4):1090-106. [14] A teaching, evaluation, and reporting platform for academic institutions. ACGME Patient Care Levels derived from cumulative Point-of-Care Grades on a 1000+ competency-based skill evaluations. Surgery for this injury is rare. We know surgeons can teach themselves most surgical skills by passive observation and trying on their own. Log in or subscribe to access all of BMJ Best Practice, symptoms 2 months and failed acute management. Travel Hacks to Manage Back and Neck Pain, Anterior Cervical Corpectomy and Fusion (ACCF), Posterolateral Gutter Spine Fusion Surgery, Posterior Lumbar Interbody Fusion Surgery, Transcutaneous Electrical Nerve Stimulation (TENS). A "sweet spot" skill is one in which the resident has completed all the prerequisite skills A fractured coccyx can be a very painful acute or chronic ordeal and may not resolve for a long duration. So, its not entirely useless. Neurologic examination was normal. Shows the % of polls that you have voted on and added supporting evidence. Find the cause of your pain. Article links allows for quick review of scientific abstracts and often the PDF is provided and can be viewed on your phone. Shortly, target cases will only include Click on the Article Selfmastery Tool on Skill Articles per the scale listed above under articles. Then slowly return to the center and rotate toward the right side. 2018 Jan;100(1):12-15. doi: 10.1308/rcsann.2017.0089. <5 this means immobility or better say rigid mobility. In cases where pain persists after surgery, standard drugs for chronic pain, such as tri-cyclic anti-depressants, may help alleviate the pain.[13]. One way of classifying coccydynia is whether the onset was traumatic versus non-traumatic. From the Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New JerseyNew Jersey Medical School, Newark, New Jersey. Roberts CS. However, people who are obese are at a higher risk for developing coccyx pain. . Type III is where the coccyx angles forward sharply. Note that, contrary to most anatomical textbooks, most coccyxes consist of several segments: 'fractured coccyx' is often diagnosed when the coccyx is in fact normal or just dislocated at an intercoccygeal joint. After the fluoroscopically guided ganglion impar block with lidocaine, she reported immediate 100% relief of her coccyx pain, with the ability to sit up on the procedure table without any discomfort at all. Generate ACGME Medical Knowledge levels through testing data, rather than through expensive and inefficient faculty evaluations. The application of heat and cold over the site also may be beneficial. By focusing faculty teaching effort on your target "sweet spot" skills, we believe we can greatly accelerate sharing sensitive information, make sure youre on a federal It may be done to remove the coccyx when all other options have been tried. your express consent. Find possible causes with our pain assessement tool. Coccydynia - could age, trauma and body mass index be independent prognostic factors for outcomes of intervention? Perhaps because the coccyx supports the pelvic floor muscles, coccydynia is 5 times more likely to occur in women than in men. The main symptom of tailbone (coccyx) pain is pain and tenderness at the base of your spine, near the top of your bottom. Intermittent ultrasound treatment will be applied to the muscles of the bilateral coccyx region at a dose of 1.0W/cm, at a frequency of 1 Megahertz, for 3+3 minutes. [5], If the anesthetic test proves positive, then a dynamic (sit/stand) x-ray or MRI scan may show whether the coccyx dislocates when the patient sits.[6]. All rights reserved. Mastery Trigger: White WD, Avery M, Jonely H, Mansfield JT, Sayal PK, Desai MJ. . Pain in the coccyx can be caused from many incidents like falling, horseback riding, or even sitting on hard surfaces for a long period of time. 2) because the contrast pattern remains just anterior to the coccyx and sacrum, where the ganglion impar is located, and seems neither intravascular nor too far anterior into the rectum. Our award-winning doctors, like Dr. Douglas Slaughter, specialize coccygectomy and minimally invasive relief options for tailbone pain! Click on the Video Selfmastery wheel to advance based on the scale below. Sagittal coccygeal movement is measured using the angle of incidenceor the angle at which the coccyx strikes the seat when an individual sits down. 70 (5): 649-53. 25 (23): 3072-9. Coccydynia can cause tenderness and a dull or achy pain in the low back or tailbone area. {"url":"/signup-modal-props.json?lang=us"}, Ebouda F, Gaillard F, Hacking C, et al. Bullets* contains medbullets and orthobullets Topics, Questions, Techniques, Cases, Videos, and Evidence. Video: Why is Exercise Important for Lower Back Pain? The information is produced and reviewed by over 200 medical professionals with the goal of providing trusted, uniquely informative information for people with painful health conditions. High Visual Analog Scale (VAS) scores prior to treatment, Type in at least one full word to see suggestions list, Orthopaedic Summit Evolving Techniques 2021, Pro: I Am For Alternative Non-Surgical Treatment: PMR, Steroids & Pain Medicine - It Will Do The Trick - Sheena Bhuva, MD, California Orthopaedic Association Annual Meeting - 2018, Do Pathologic Changes on Imaging Studies Make Spines More Vulnerable to Injury? For this reason, patient selection is crucial to a positive surgical outcome. 2. This pain condition normally resolves with supportive care but can occasionally become persistent. Coccygodynia - About the Disease - Genetic and Rare Diseases Curr Pain Headache Rep. 2018 Mar 19;22(4):28. doi: 10.1007/s11916-018-0683-7. Medicine can help ease pain and swelling. of all the articles and have met specific Orthobullets inclusion criteria. The site is secure. The doctors at NJ Spine and orthopedic are in my opinion top notch. This site needs JavaScript to work properly. Bullets* - Apps on Google Play Tailbone Pain (Coccydynia): Relief, Symptoms, Treatment & Causes Coccydynia Coccydynia. Postacchini F, Massobrio M. Idiopathic coccygodynia. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. On either side of the posterior surface are the coccygeal cornua, which articulate with the cornua of the sacrum to form the posterior sacral foramen, occupied by the posterior division of the fifth sacral nerve. On this Wikipedia the language links are at the top of the page across from the article title. Please try again soon. Physical Synergy A coccyx fracture is a break in the tailbone. "Clinical and radiological differences between traumatic and idiopathic coccygodynia", "Coccydynia/Levator Syndrome, A Therapeutic Test", www.coccyx.org, website about coccydynia causes, treatments and coping with the condition, Coccyx pain, tailbone pain, coccydynia review article at eMedicine via Medscape, https://en.wikipedia.org/w/index.php?title=Coccydynia&oldid=1137197005, Short description is different from Wikidata, Creative Commons Attribution-ShareAlike License 3.0, 31% Not possible to identify the cause of pain, 27% Hypermobility (excessive flexing of the coccyx forwards and upwards when sitting), 22% Posterior luxation (partial dislocation of the coccyx backwards when sitting), 5% Anterior luxation (partial dislocation of the coccyx forwards when sitting), This page was last edited on 3 February 2023, at 09:25. The classic presentation of a coccyx fracture is localized pain over the coccyx. Save your CCC team 120+ FTE hours doing ACGME evaluations via our automated platform. He denies constitutional symptoms. Does not include Technique Guides or Approaches, Coccydynia: A Review of Pathoanatomy, Aetiology, Treatment, and Outcome. Coccydynia is a medical term meaning pain in the coccyx or tailbone area, often brought on by a fall onto the coccyx or by persistent irritation usually from sitting. Too much more or too much less, can be a sign of a problem. Target Content: Practice Essentials. Study design: Coccygectomy tends to be most successful in carefully selected cases. Coccydynia (also referred to as coccygodynia or tailbone pain) is pain at the coccyx. Mastery Trigger: Coccydynia is a painful disorder characterised by coccygeal pain which is typically exaggerated by pressure. A total of 184 patients were operated with coccygectomy in our department and followed-up with questionnaires after a minimum of 1 year post-operatively. [ 1] (. evidence, and to think critically. Unable to load your collection due to an error, Unable to load your delegates due to an error. Advice on bowel habits: staying hydrated and consuming fibre to prevent constipation; adopting a optimal posture for emptying bowels completely. Save FTE hours across your entire team when generating ACGME Biannual reports. Orthobullets has done the hard work of filtering for the evidence of which you need to be aware. Proper equipment used to preventing coccyx pain, Stretches and strengthening exercises for prevention. ??accessibility.screen-reader.external-link_en_US?? Click the PEAK Tracker below to see how you rate mastery of different learning activities. 12 (1): 49-54. Commonly, coccydynia (coccygodynia) occurs after trauma and appears with normal imaging features at static neutral radiography, but dynamic imaging with standing and . A fractured coccyx can be a very painful acute or chronic ordeal and may not resolve for a long duration. Take notes and highlight so you don't forget what you learned. Copyright 2023, New Jersey Spine and Orthopedic. Perhaps the biggest difference between surgeons is that some remove only part of the coccyx, while others recommend removing the entire coccyx. Two types of radiographs: coccyx scoliotic deformity (AP and lateral), number and morphology of coccygeal segments, intercoccygeal angle ( between the first and last segment of the coccyx), in idiopathic coccydynia was greater than that of traumatic, useful radiological assessment to evaluate the anterior angulation of the coccyxand its deformity, normal pivot of the coccyx lies between 5 and 25. Questions work best in repetition, where you see the question over and over again, 1 Topical NSAIDs application. 2 specific "core" cases that have been through a specific editorial process and have a certain teaching objective. Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Password. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Broken Tailbone Symptoms, Diagnosis, Treatment, and Care - Healthline Coccyx removal surgery can be a treatment for a badly damaged coccyx, but is more often used for patients with long-term chronic coccyx pain conditions. Coccyx Fractures - Physiopedia Target Content: This includes the Orthobullets "Steps" for each Skill. Topical creams are generally well tolerated and can be associated with fewer systemic side effects than oral medications. The coccyx may be tender on examination. History may be significant for a recent trauma with an acute onset of pain, or the onset of pain may have been insidious with no clear inciting factor. In type I the coccyx is curved anteriorly with its apex facing downward and caudally. The coccyx itself is made up of 3 to 5 vertebrae, some of which may be fused together. Vote on case polls AND add supporting evidence via Pubmed Insert Evidence Tool. Have a stream of hot or cold water run down your back continuously if pain becomes unbearable. getting up from a seated position. See Treatment and Medication.) Have your CCC review ACGME Medical Knowledge levels virtually with the ability to override values based on other sources of performance data. 2016 Apr;98-B(4):526-33. doi: 10.1302/0301-620X.98B4.36641. Schedule outpatient follow-up visit within 4 weeks. However, our physicians will be offering ONLINE appointments during this time to address your medical needs. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. Read full article carefully and reviewed References. government site. 1 The above patient's symptoms . (1999) Yonsei medical journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963058/, https://www.winchesterhospital.org/health-library/article?id=11953, https://www.healthline.com/health/broken-tailbone#symptoms, https://www.physio-pedia.com/index.php?title=Coccyx_Fractures&oldid=306874, Having a health problem that may result in falls, such as weak, Having a health problem that may weaken bones, such as. Track your residents though a Technique Guides & Skillmaster of 150+ procedures with videos, articles, quizzes and self-mastery tracking. Orthobullets | 4,616 followers on LinkedIn. An obese 70-yr-old woman presented with severe focal coccyx pain (coccydynia) after sitting on the relatively narrow seat of a stationary bike. Got question correct and read the explanation and conclusion of the abstracts. Use of this content is subject to our disclaimer. Symptoms of spinal cord injury include: Severe neck or back pain . A number of different conditions can cause pain in the general area of the coccyx, but not all involve the coccyx and the muscles attached to it. In other words, the coccyx for obese people may be more posteriorly outward when they are sitting down. Currently all videos linked to a topic count in this counter. A one to two-inch incision is made over the top of the coccyx, which is located directly under the skin and subcutaneous fat tissue. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Now type in the correct response and select it from the drop down menu to advance to 100%. Epub 2021 Sep 7. Ochsner J 2014; 14:8487. 2. Failed Back Surgery Syndrome (FBSS): What It Is and How to Avoid Pain after Surgery, What Causes Buttock Muscle Pain and How to Relieve it, Piriformis Syndrome: When the Symptoms Indicate a Medical Emergency, Massage to Reduce Buttock Muscle Pain from Piriformis Syndrome, Suffering from Lumbar Spinal Stenosis? Intermittent ultrasound will be used as a physical therapy agent. However, the tailbone does serve as the point of attachment for several key muscles, ligaments, and tendons. Roberts CS. Orthobullets Techniques are largerly incomplete at this time, and will see rapid improvement leaning back while seated. coccydynia orthobullets After attaining sufficient pain relief so movement is better tolerated, daily low-impact aerobic activity is beneficial, as the increased blood flow brings nutrients to the area and encourages the bodys natural healing abilities. External trauma causing a fracture usually occurs due to a backward fall on the buttock eg a fall off the stairs on the tailbone, or by an impact directly applied to coccyx. Her symptoms persisted for many weeks, despite oral analgesics, use of additional cushions while sitting, and cessation of cycling. Case 1: with anterior angulation of coccyx, View Fakhry Mahmoud Ebouda's current disclosures, View Frank Gaillard's current disclosures, see full revision history and disclosures, Biogen Australia Pty Ltd, Investigator-Initiated Research Grant for CAD software in multiple sclerosis: finished Oct 2021 (past). chocolate pudding incident rugrats; stabbing pain in left groin female; leningradets vs fc zenit 2 st petersburg; recipes with cocoa powder no sugar; jeannie russell bill russell wife; deck mounted skylight; cleveland clinic london news; A competency based surgical skill training & evaluations system that is mobile, user-friendly, and improved technical training. Is Minimally Invasive Spine Surgery Right for You? Careers. If your hospital, university, trust or other institution provides access to BMJ Best Practice through services such as OpenAthens or Shibboleth, log in via this button: Access through . 5.0 (5) CASES (1) Back pain and bilateral hip pain . 1173185, Livingstone L. Post-natal management in: Sapsford R, Bullock-Saxton J, Markwell S. Womens health: a textbook for physiotherapists. Wray CC, Easom S, Hoskinson J. Coccydynia. Coccydynia is a common condition that is known to be difficult to evaluate and treat. Coccygectomy Surgery for Coccydynia (Tailbone Pain). Introduction. Mastery Trigger: The information is produced and reviewed by over 200 medical professionals with the goal of providing trusted, uniquely informative information for people with painful health conditions. Studies have shown that these preparations are useful for other painful conditions such as osteoarthritis. That is usually the journal article where the information was first stated. Spine Journal 2.5.23 (2000): 3072-3079. Another less common mechanism is by pressure from the passage of the fetus down the birth canal during delivery. Objective: Throughout her follow-up visits for unrelated conditions, she has continued to report 100% relief of her coccyx symptoms, without any coccydynia recurrence even 1 yr later. Buttaci CJ, Foye PM, Stitik TP: Coccydynia successfully treated with ganglion impar blocks: A case series. (1958) Radiology. Coccydynia. https://www.cure-back-pain.org/fractured-coccyx.html, Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome, https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.92B12.25486. Did read the conclusion of Abstract & Bullets and highlighted some parts of it. Only Orthobullets "Tested" articles count as target content. Know your condition? Dr. Ebraheim's educational animated video describing anatomy of the coccyx (tailbone) as well as treatment of specific injuries associated with the coccyx.Th. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). The coccyx can be composed of several sections of 2 or more bones each. have a certain educational value and quality control will count in this counter. Rarely, even sexual intercourse can aggravate symptoms. I'm truly grateful to all the doctors at NJ Spine and orthopedic. Clinical and radiological differences between traumatic and idiopathic coccygodynia. as they are updated by experts in the field over the coming months. Get unlimited access to study plans, including OITE, ABOS, and CORE Curriculum. 1 The mechanism of injury, if identified, may include trauma (e.g., falls, childbirth, horseback riding). Tailbone pain, or coccydynia, can be a dull ache or a sharp pain at the bottom of your spine. (2005) The Journal of trauma. American Journal of Physical Medicine & Rehabilitation85(9):783-784, September 2006. Read More . Your performance data is safely gathered and stored for program use only. Log in | BMJ Best Practice Physical examination will reveal tenderness over the coccyx. Coccydynia is a term used to describe a painful coccyx. At-home remedies for tailbone pain (coccydynia) include: Taking a NSAID like ibuprofen to reduce pain and swelling. The overall success rate was 71%, defined by patients being either completely well or much better at final follow-up. Easily create ACGME Biannual Milestone reports and summative end-of-rotation evaluations for all ACGME core competencies - saving hours in CCC meetings! coccydynia orthobullets While it is unlikely, it is possible that if this were to happen, a diverting colostomy would be necessary to allow the rectum to heal. The aim of this article was to evaluate the results of patients operated for chronic coccydynia, and determine any factors that could affect outcomes. Anatomy Structure . Coccydynia may also be caused by sitting improperly thereby straining the coccyx. Tried to teach surgical "Step" to another surgeon. Coccydynia | Radiology Reference Article | Radiopaedia.org Nathan ST. Fisher BE. Orthobullets, Retrieved from . Results. unless you have done your homework. The Orthobullets Podcast on Apple Podcasts Prevention of carrying excessive weight gain can help reduce the tension and pressure on the coccyx. Positive straight-leg raise with patient distraction, Diffuse tenderness with palpation of the paraspinal lumbar musculature, Lower extremity numbness in a non-dermatomal pattern, Pain with simulated rotation of the lumbar spine. Patients with coccydynia who do not respond to conservative treatment will often profit from coccygectomy. The adductor magnus is involved in the kneeling groin stretch, and when it is tight it can contribute to tailbone pain, so stretching can help prevent tailbone pain. Veritas Health, LLC, 520 Lake Cook Road, Suite 350, Deerfield, IL, 60015. Coccydynia. Call 911 and avoid moving the person if they have signs of spinal cord injury along with a tailbone injury caused by a fall. Fracture of base of second metatarsal is pathognomonic. Take the pain out of ACGME reporting. PMC The suffix -dynia means pain. Next, local anesthetic is injected, thus blocking the ganglion impar. Click on the Topic Selfmastery wheel to advance based on the scale below. The physician uses imaging guidance to ensure that the injection is administered . sciatica, infection (including shingles of the buttocks), pilonidal cysts, sacroiliitis, and. (2006) Spine. Answer the question correctly 3 times in a row to advance to 80%. Fracture can also occur from repetitive or prolonged sitting on hard, narrow, or uncomfortable surfaces,particularly with osteoporotic bones. Coccydynia is also known as coccygodynia or tailbone pain. Obtain Long Term Pain Relief. Conservative management includes pressure-relieving cushions, local corticosteroid injections, and/or coccygeal manipulation. Orthobullets | LinkedIn Stiffness of the hips and lower back after waking is common. For each of these "Steps" the surgeon rates his Self-mastery on the scale listed below. Coccyx pain (tailbone pain) can frustrate patients and significantly impair quality of life, but relief is possible. (Chronic coccyx pain is termed coccydynia). The main complication after this procedure is infection, and the risk can be somewhat reduced by using antibiotic prophylaxis for 48 hours after surgery. 7. An injury or trauma may cause inflammation of the coccyx, but it may occur seemingly spontaneously. Analytics to improve Physician Development. Ensure a higher quality of care in the OR by identifying which residents are ready for advanced procedures. Surgery (coccygectomy) is highly effective in recalcitrant post-traumatic coccygodynia. Mastery Trigger: Which of the following is the strongest negative predictor for a successful clinical outcome with non-operative treatment? If the above treatments do not help manage or alleviate coccyx pain, additional treatments administered by a doctor, chiropractor, or other medical professional may be necessary. Repeat the procedure in intervals of 5-6 minutes. [3] Childbirth is rarely responsible for actually causing a fracture of the tailbone. Coccygodynia is a rare condition in that causes pain in and around the coccyx (tailbone . The most difficult part of the operation is the long healing process. sexual intercourse. 73 (2): 335-8. As a senior resident you should focus more on operative treatment, techniques, and complications. Number represents % of total requred Skill Tasks completed. J Bone Joint Surg [Br] 2010; 92-B: 1622-7. The coccyx is the small bone located at the very bottom of your spine. The tendon of the iliococcygeus muscle attaches to the tip of the coccyx, protecting the rectum and supporting it via the coccyx[2]. The normal range of motion is about 13 degrees. Nathan ST. Fisher BE. Maigne and Tamalet applied this treatment to 86 patients under fluoroscopic guidance. Mastery Trigger: Treatments for coccydynia are usually noninvasive and include activity modification. Anterior angulation of the coccyx | Radiology Reference Article Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Coccydynia is the medical term for tailbone inflammation. As a junior resident you should focus on presentation and nonoperative treatment. Top Contributors - Kim Jackson, Lucinda hampton, Rosie Swift and Admin, A coccyx fracture is a break in the tailbone. Maigne, Jean-Yves, and Doursounian Levon. Rarely, coccydynia is due to the undiagnosed presence of a sacrococcygeal teratoma or other tumor in the vicinity of the coccyx.[1]. Training patients to adopt proper sitting posture ensures that weight in distributed through the ischial tuberosities, therefore decreasing the pressure transmitting through the coccyx. The location of the coccyx makes it particularly susceptible to internal injury, including fractures, during childbirth, especially during a difficult or instrumented delivery. Coccygodynia: evaluation and management. It is the last section of the ape vertebral column. Identify surgical skill deficiencies and adjust rotations schedule to ensure all residents meet their ACGME Patient Care Skills by graduation. Skalski M, Matcuk G, Patel D, Tomasian A, White E, Gross J. Coccydynia is a fairly common injury which can often result from falls, particularly in sports such as cycling, skateboarding, skating or ice hockey. A kneeling groin stretch can help prevent coccyx pain from occurring after long periods of sitting. While the surgery itself is a relatively straight-forward operation, recovery from the surgery can be a long and uncomfortable process for the patient. In type II this forward curvature is more dramatic and the apex extends forward. 1999-2023 Veritas Health, LLC. Increase your OITE scores and pass the boards without stress by utilizing our Qbank of AAOS SAE questions and OB question! The coccyx can be composed of several . of a Technique textbook, which we feel should be read prior to attempting to do a surgical skill. Coccyx pain (coccydynia, coccygodynia) is caused by various pathogeneses, including fracture, sprain of the sacrococcygeal junction or intercoccygeal segments, infection, tumor, and degenerative changes.

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