21 The dimple has an underlying tract of epithelial and fibrous tissue that pierces the underlying fascia and posterior vertebral elements, pierces the dura, and tracks. Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory and motor problems and loss of bowel and bladder control. k. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. Dimple is less prominent. a dimple on the chin. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. Deep dimples. We should probably be reassured that it hasn’t been flagged with us! 1. If a sacral dimple is paired with other symptoms such as bruising, tufts of hair or skin tags, it could be a sign of a spinal condition. g. 12), especially if any discharge is observed or reported. Definition. A butterfly- shaped rash across your nose and cheekView article titled, Lumbosacral Nevus Simplex in a Newborn Girl with an Asymmetrical Y-Shaped Gluteal Cleft. Hamoud et al. g. However, many children without spinal dysraphism also have these skin. His chromsome deletion also has tethered cord listed as a possible diagnosis. It is a visible border separating ass into two parts. She said this could mean she has a tethered spinal cord. Data were analyzed on 151 newborns; average age at the time of USG was 1. not associated with other cutaneous stigmata of spinal dysraphism (e. A comprehensive review of 200 patients with spinal dysraphism found that 102 had a cutaneous sign. Spina Bifida Occulta (Occult Spinal Dysraphism) Spina bifida occulta is a common anomaly consisting of a midline defect of the vertebral bodies without protrusion of the spinal cord or meninges. Skin stigmata were classified into seven types, dimple, deformed gluteal cleft, hair, subcutaneous mass, appendage, discoloration, and protruding bone, and included 1056 isolated and 199 complex ones. Asymmetric Y-shaped gluteal cleft that is moderately associated with spinal dysraphism except if present with other lesions. It is found in the small of the back, near the tailbone, which is also known as the sacrum. The mimics are confined to the gluteal cleft while a DST originates above the cleft and can communicate with the spinal canal and dura mater [2, 5]. Sacral dimples, also known as sacrococcygeal or coccy-geal dimples or pits, are the most common cutaneous. At 6 months all her lanugo fell off except this little patch of hair on her low back and it looks like a little grey spot above the gluteal deviation. It can be mistaken for other causes of low back pain. Genital psoriasis can affect the buttocks, gluteal cleft, genitals, and surrounding areas. Both sexes are equally affected. Then, the surgical wound is closed by rotating other tissue to cover the area. • The presence of more than one skin dimple anywhere along the neural axis is an indicator of the likely presence of OSD. There is no dimple or hair just the y shaped cleft. This is not noticed when your child has on clothing. The patient’s mother had adequate prenatal care and a normal. The sacrum consists of five fused sacral vertebral and costal segments (numbered one-to-five) that form a central sacral body and paired. Dimples can also occur higher up above the gluteal cleft. Both are considered mild birth defects. Code Tree. Sacral dimples. Zywicke and Curtis J. News & World ReportA sacral dimple is a small, usually shallow indentation in the small of the back, just above or within the crease of the buttocks. What is the ICD-10 code for sacral dimple?. 5 cm above the anus or proximate to the coccyx, and deviated gluteal folds (DGF) including all types of folds (bifid and split symmetrical without underlying. Inflamed, swollen skin. Symptoms of Tethered Spinal Cord. An approach to ultrasound investigation of sacral dimples is presented in . PMID:Y shaped gluteal waiting for scan. @lblake907, in some cases it’s a sacral dimple and can be a sign of spina bifida occulta, but if the spine is closed then it can be (in very rare occurrences) a sign of a tethered cord. GLUTEAL CLEFTS Although the Nelson Textbook7 states that imaging requirement is considered “uncertain” for gluteal fold deviations, several experts have said that an asym- metrical or bifurcated gluteal cleft may be a fairly good harbinger of occult spinal dysraphism. Brent R. A sacral dimple is a small dimple or cleft at the base of the spinal cord. According to his. skin tags. Those with OSD had a mean dimple position of 15A sacral dimple is an indentation or pit in the skin on the lower back that is present at birth in some babies. Sacral dimples can appear anywhere between the lower back and the top of the buttocks. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. There are no differences reported among ethnic groups. Of our soft-tissue appendages, two were surrounded by patches of hypertrichosis. Respondents would obtain imaging in 57%, 89%, and 65% respectively. In contrast, for patients with a low-sacral dimple, flat hemangioma, and symmetric (Y-shaped) splaying of the intergluteal cleft, opinion on the need for imaging varied considerably (between 57%. 10 Albright,12 a neurosurgeon from Wisconsin, estimated a notably high A B. Gluteal Region is the back and side of lateral half of pelvic region. 06 [convert to ICD-9-CM] Epigastric swelling, mass or lump. Bowel movements, penetrative sex, and orgasm can also be a source of aggravation for the tailbone. The doc looked at their butt cracks and my daughter's has a crooked crease right at the top. 1 Atypical Sacral Dimple: Not in midline, not in sacrococcygeal region, >5 mm deep, >2. nervous system sacral dimples Pediatrics in Review Vol. This can cause problems starting around age 2-3 (potty training age) is when parents start to see some signs. Sacral and gluteal pressure wounds are a common problem in elderly and critically ill patients. However, if the sacral dimple is deep and large, greater than 0. Anonymous. org. @lblake907, in some cases it’s a sacral dimple and can be a sign of spina bifida occulta, but if the spine is closed then it can be (in very rare occurrences) a sign of a tethered cord. If the base could not be seen, this would be called a coccygeal pit. B. Includes. cleft, isolated symmetrically deviated (Y-shaped) gluteal cleft, “other isolated cutaneous stigmata,” a combination of 2 or more of any of the cutaneous markers listed above (“multiple cutaneous stigmata”), or a congenital malfor-. Ultrasonography (US) of the spinal cord is performed in newborns with signs of spinal disease (cutaneous lesions of the back, deformities of the spinal column, neurologic disturbances, suspected spinal cord injury due to traumatic birth, and syndromes with associated spinal cord compression). Figure 4. [Zywicke, 2011] Neural Tube Defects: [Zywicke, 2011] Open vs Closed When an infant is born with skin lesions or abnormalities of the lower back or gluteal cleft, the possibility of an association with spinal malformations, such as tethered cord syndrome, often prompts pediatricians to recommend spinal imaging. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. It's usually located just above the crease between the buttocks. In patients with a sacral dimple, the location of the dim - J neurosurg Pediatr). He did great & slept through the whole thing. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in. CrossRef Google Scholar Odili J, Gault D (2002) Laser depilation of the natal cleft—an aid to healing the pilonidal sinus. A dermal sinus tract is a rare neural tube defect and. 5%. typically beginning cephalad to the gluteal cleft and extending. Sacral dimples which have a clearly visualised base with a width of < 0. Any dimple lying superior to the gluteal cleft, outside the midline, and with a diameter greater than 5 mm commonly accompanies a spinal anomaly and warrants. ICD 9 Code: 685. 14, 15, 22, 36 Most infants with sacral dimples that fall within the gluteal crease are healthy. 3 March 2011 111The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, [1] so named because it forms the visible border between the external rounded protrusions of the gluteus maximus muscles. 3. defined the infragluteal fold as a result of gluteal ptosis secondary to sagging of the buttocks and redundant gluteal tissue [ 9 ]. Lipoma of the terminal filum Less severe form of Occult SD More than 2 mm thickness of the filum on MR imaging Frequently assosciated with sacral/gluteal cleft dimples. Sacral dimples that are accompanied by a nearby tuft of hair, skin tag or certain types of skin discoloration are sometimes. Those with OSD had a mean dimple position of 15 mm (SD 11. above the gluteal cleft. A few dimples were located in the upper portion of a deviated or Y-shaped crease and were therefore slightly off-midline even though located within the gluteal crease. ICD-10-CM Diagnosis Code L05. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). This is the American ICD-10-CM version of Q82. It is found in the small of the back, near the tailbone, which. Sacral epidermal anomalies include dimples, tracts, lipomas, hemangiomas, and tufts of hair and may be associated with a neural tube defect, such as spina bifida. 6 is exempt from POA reporting ( Present On Admission). Hypertrichosis. 2,4–6 Variations between practicing clinicians with respect to the management of. The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). kdmahnke13. These cysts are usually caused by a skin infection and they often. (1) (2) These defects, which result from abnormal fusion of the neural tube during embryonic development, are placed into two broad categories: open and closed. They do not. 5%. Those with OSD had a mean dimple position of 15 mm (SD 11. simple sacral dimple, defined as a midline dimple, within the gluteal cleft and without associated cutaneous abnormalities, is a common finding and. I've never heard of such a thing before he was born. 8. ICD 9 Code: 685. hairy tuft, rudimentary tail, hemangioma)E. The GP said her development was totally normal and she didn't even have a sacral dimple, just the Y cleft and with the signs she wouldn't normally refer her on but would for us to put our minds at rest, that was at 9 weeks and it's taken this long to get. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. More than one hole may develop, and often these are linked by tunnels under the skin. The purpose of this study was to analyze unusual and complex dysraphism and propose a new classification based on clinicoradiological correlation and anatomical location. The examination is performed with high-frequency. 4. An approach to ultrasound investigation of sacral dimples is presented in . 4 ). Additional findings that we observed on clinical examination were sacral dimple in 3 patients (2 with benign sacral dimple and 1 associ-ated with asymmetrical gluteal cleft) and a dermal sinusFunction. 8% to 7. Albert G (2016) Spine ultrasounds should not be routinely performed for patients with simple sacral dimples, Acta Paediatrica, 10. 5 cm above the anus) and solitary. A sacral dimple is a small indentation (dent) in the lower back, near the crease of the buttocks. Tinea cruris is usually due to T. 3,. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. Skin stigmata were classified into seven types, dimple, deformed gluteal cleft, hair, subcutaneous mass, appendage, discoloration, and protruding bone, and included 1056 isolated and 199 complex ones. There is no skin. Fig. Figure 1 shows the number of patients within each of these groups who did and. Has anyone had any expierence with this ?Lumbosacral dimples and coccygeal dimples (pit) of the midline spine are one of the most controversial areas in pediatric neurosurgery. g. 0): 602 Cellulitis. Babies with congenital hip dislocation can also have asymmetrical gluteal folds but that is part of the newborn exam so I'm sure the doctor checked for that as well. 5 cm, and falls within the superior portion or just above the gluteal cleft, and/or is associated with other cutaneous markers for neural tube defects, the infant is more likely to have an underlying neural tube defect. A sacral dimple is an indentation, present at birth, in the skin on the lower back. Sacral dimples are benign lesions, overall, especially as a solitary finding with no associated skin stigmata, and as such do not require further imaging. Q82. Figure 2. (1) (2) These defects, which result from abnormal fusion of the neural tube during embryonic development, are placed into two broad categories: open and closed. MeSH Code: D010864. Simple sacral dimples require no further investigation whereas complex ones do. Code Tree. 5. 2, 3 Abnormal antenatal US scan of spinal column 4. S. , saddle numbness and tingling, or weakness in arms or legs) Neurogenic BBD (spinal anomalies, transverse myelitis, central nervous system. sacral dimples and other stigmata of spinal dysraphism. In most cases, pilonidal dimples are benign and may just be accompanied by increased hair growth in the area. hairy tuft, rudimentary tail, hemangioma) E. The skin may look inflamed, smooth, or scaly, and may feel itchy and uncomfortable. There are several names for this area: natal cleft, gluteal crease, gluteal crevice. Sacroiliitis can cause pain and stiffness in the buttocks or lower back, and the pain might go down one or both legs. Other findings indicative of a post-neurulation defect…One of the common forms of skin stigmata is the sacral dimple, with an incidence of 1. The hip line become curved in this. ICD-10-CM Diagnosis Code M76. Sacral dimples should be. It is present by birth in babies. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. Base of dimple is visible. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. Advertisements. EQUIPMENT: Linear array transducers: EPIQ 7G L12-5. Urinary and bowel dysfunction are nearly universal. Open the PDF for in another window. Stumbling or changes in gait or walking. He had an ultrasound at a week old and it was negative. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. Simple sacral dimples are present in 3–5% of newborns are not associated with increased risk of neural tube defects or dermal sinus tracts []. Y Shaped Bottom Cleft. A duplicated gluteal cleft associated with occult spinal dysraphism. In association with other OSD associated. Such{{configCtrl2. Infants with a simple sacral dimple, with evidence of abnormal neurologic or orthopedic exam findings should be further evaluated F. 5 cm from the anal verge), or associated with other cutaneous markers. little man has a duplicated gluteal cleft. In contrast, for patients with a low-sacral dimple, flat hemangioma, and symmetric (Y-shaped) splaying of the intergluteal cleft, opinion on the need for imaging varied considerably (between 57%. 8 may differ. PATIENT PREPARATION:The lower back plays a pivotal role on the general gluteal shape and should be addressed properly . We should probably be reassured that it hasn’t been flagged with us! 1. I almost thought they just made that up!Download MyChart to connect with your care team. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of having a tethered cord. • Associated with skin tag. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. They are more common in people of German and Polish ethnicity. 8) above the coccyx. Simple coccygeal dimples are small (less than 5 mm in diameter) and shallow, with a visible base and straight orientation. No other skin changes are seen. 예전에는 잘 알려지지 않았지만. Corbett Wilkinson, Michael H. worried for my 7 weeks old son. A sacral dimple is defined as a midline dimple less than 5 mm in diameter and no further than 2. Not Included Here. Includes. If you have to split the glutei to see the dimple, then this is low-lying and less suspicious for dysraphism. Sacral Dimple. All simple dimples were within the gluteal crease and had a visible, skin-covered base; all were <5 mm in size. Usually occur in combination of other masses, e. As the tittle says I am currently waiting on a back scan for my little man hes 14 weeks old hes got a y shaped gluteal cleft, it feels dead boney where this is. Low-risk findings included “simple dimple,” defined as a soft tissue depression appearing up to 2. In general, simple cutaneous lumbosacral markings , such as a simple sacral dimple or Y-shaped gluteal cleft, are unlikely to be associated with an underlying OSD. It is the most common site of intra. If the base could not be seen, this would be called a coccygeal pit. At her check up her doctor noticed that she has a y shaped gluteal crease. 77 days. HandlerIndications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in. Answer: Sacaral dimple. 2013 Oct;98(10):784-6. A sacral dimple is a small dimple or cleft at the base of the spinal cord. Sacral dimple ultrasound – sagittal ultrasound showing normal conus level and no underlying spinal dysraphism (red circle is approximate area of cutaneous sacral dimple) The vertical line starts from sacrum to the perineum. Three had associated asymmetric or Y-shaped gluteal clefts. [Wu, 2020] ~2-4% of all newborns have a sacral dimple. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. 6 may differ. with sacral dimples (Table 3) and found 41 cases (15. They’re caused by short ligaments connecting your pelvis to your skin, but they have no. 7. 5 cm from the anus. @BekaRoo, you would think so but I guess they see so many babies each day that they probably see a lot of sacral dimples and don’t think to mention it unless it’s very obviously a concern. (b) X-ray showed absent sacral elements. Lastly, in the presence of isolated sacral dimple, hypertrichosis, small hemangioma, and pigmentary nevus, which are linked to a very low risk of OSD, we propose only a clinical evaluation. It is a congenital condition, meaning it is there when the baby is born. A simple sacral dimple, defined as a midline dimple, within the gluteal cleft and without associated cutaneous abnormalities, is a common finding and considered to be a. It covers the area from iliac crest from above to the gluteal fold below. Multiple dimples were encountered. Lumbosacral dimples are common but can be a sign of spinal dysraphism. It is a Y-shaped fissure on. The area seemed tender to the touch and was without spontaneous drainage. Sometimes during a caudal block, you’ll see a midline sacral dimple. Sacral dimples that are. Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. 2, 3 As one of the patients was initially described by Oberklaid and Danks, 2 this syndrome is sometimes. A crooked crease between the buttocks. 8. • Subcutaneous mass or lipoma (sometimes seen as deviation of gluteal fold) • Hairy patch • Dermal sinus ( Sinuses opening onto skin surface, located above gluteal cleft and have a cephalically oriented tract) • Atypical Dimples : o Deep (>5mm) o >2. 5 × 1-cm lumbosacral skin appendage (black arrow), slightly to the left of midline, plus a y-shaped gluteal cleft. <2. Ems0. She had no dimples or sacral tuft. Bohring–Opitz syndrome (BOS) was first described in 1999 by Bohring et al, 1 who described four new patients and identified similarities with two patients who had previously been reported as having Opitz C syndrome. Multiple dimples were encountered. hemangioma at site of dimple and spreading to anus. The hip joint is the most stable joint in the body and is supported by a very strong capsule and several. Yes my son has that. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of. Although frequently referred to as “sacral dimples,” the lesion is a whorl of skin that tracts to the coccyx . The management of some types of lumbosacral vascular marks and gluteal crease deviations had poor agreement (< 70%). This can cause problems starting around age 2-3 (potty training age) is when parents start to see some signs. A pilonidal cyst can be extremely painful especially when sitting. A coccygeal pit is a very low lying dimple with the pit pointing towards the coccygeal tip. The aim of this study was to determine the clinical. Topics: Neural tube defects are among the most common forms of birth defect, affecting 1 in every 1,000 pregnancies. k. To differentiate these clinical mimics and to exclude DST in patients with sacral dimples, magnetic resonance imaging (MRI) is frequently indicated [ 5 ]. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in. From a posterior-anterior view, the gluteal region may be divided into two symmetric “flank” units, “sacral triangle” unit, two symmetrical gluteal units, two symmetric thigh units, and one “infragluteal diamond” unit. Congenital sacral dimple. Simple sacral dimples require no further investigation whereas complex ones do. Dimples associated with a lumbosacral dorsal dermal sinus are usually midline dimples, located above the gluteal cleft, more than 2. There was no difference in the rate of OSD based on dimple location. Sacral Dimples and Pits: Background. Sacral and back dimples are congenital, which means you are born with them. 3). Another back dimple appears closer to the crease of the buttocks, on the skin covering the sacrum. 5 cm of the anus without any associated abnormal masses or skin lesions. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. nervous system sacral dimples Pediatrics in. 2 and. [Wu, 2020] Have been associated with Closed Neural Tube Defects. Caution: Not every dimple, opening or abscess in the sacral regions is pilonidal disease. “Midline lumbosacral skin lesions (e. Posted 06-23-17. Sacral dimples are rare and appear in only around four percent of the population. 5 cm from the anus) 2. Simple sacral dimples require no further investigation whereas complex ones do. Photographs of commonly noted lumbosacral cutaneous physical examination findings. The y shaped cleft was still there and didn't go away as pediatrician hoped. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in. 8 became effective on October 1, 2023. 6 - Congenital sacral dimple. In this design, the advancement is done in a V-Y fashion and the medial portion of the flaps are elevated and advanced to cover the sacral defect. Remove the tibia and fibula. The MyChart Patient Portal is an online tool that provides medical information about care provided at Johns Hopkins All Children’s and connects you to your health care team. Intermediate Risk Category • Imaging is required in the following circumstances (ultrasound if age <6 months or MRI if age ≥6 months):6, 14,25 An atypical dimple is larger than 5 mm and located within 25 mm of the anus. e. Additional/Related Information. This can then lead to the subsequent formation of a subcutaneous. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. There was a cold, fluctuant firm, skin covered, dusky coloured fleshy swelling over the sacral region just to the left of the midline with ill-defined finger-like projections/lobulated margins at its lower border (Fig. Apr 24, 2016 at 7:40 PM. 273 results found. e. {{configCtrl2. 5 cm, and falls within the superior portion or just above the gluteal cleft, and/or is associated with other cutaneous markers for neural tube defects, the infant is more likely to have an underlying neural tube defect. • Subcutaneous mass or lipoma (sometimes seen as deviation of gluteal fold) • Hairy patch • Dermal sinus ( Sinuses opening onto skin surface, located above gluteal cleft and have a cephalically oriented tract) • Atypical Dimples : o Deep (>5mm) o >2. Use anatomic landmark descriptors when documenting findings. 8. of the dimple. POA Exempt. Expand. Applicable To. ManagementSimple solitary dimples located within the gluteal cleft without evidence of drainage do not warrant further investigation. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. We would like to show you a description here but the site won’t allow us. A sacral dimple is found in the gluteal cleft, and you will need to separate the glutes to find it. Anyway, my husband pointed it out again to the doctor at the 6 mo follow up. It will not respond by adding volume with fillers or fat and the only. To date, the association with KS and closed NTD or tethered cord. The 2022 edition of ICD-10-CM Q82. Original poster's comments (2) 0. Nate has a wonky "Y" shaped butt crack and his second/third toes are slightly syndactyl (sp?). 6 became effective on October 1, 2021. had a sacral dimple, 34 had deviated gluteal cleft, 24 had tuft of hair, 1 had a sacral nevus, 1 had sacral puckering and 1 was described to have sacral fullness. We would like to show you a description here but the site won’t allow us. Sacral dimple newborn. They did an ultrasound of his booty & spine when he was like a week old. Ringworm infection of the feet might show redness and blisters in addition to scaling. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. Decision to use ultrasound vs MRI as first-line imaging is somewhat institution dependent G. 6% in normal newborns [1, 10,11,17]. tenderness. ”Simple sacral dimples or pits (solitary dimple, < 5mm in diameter, situated in the. 7 The diamond’s lateral angles correspond to the sacral dimples, and its inferior angle is positioned at the upper border of the intergluteal cleft. 5). These bilateral lines create a desirable sacral diamond on the patient’s lower back, which mimics the rhomboid area of Michaelis. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. A dimple above the gluteal crease (the crease in the buttocks) Long hair (longer than 1 inch) growing on the back over the spine. 6 - Congenital sacral dimple. Some authors tried to propose a higher threshold score based on the five-point scoring system, however, it did. Gluteal retractions (GRs) may be defined as depressions on the buttocks surface, caused by pathologic conditions at the level of either the subcutaneous tissue, fascia, or muscular fibers, or the association of these levels, which may have aesthetic and sometimes functional consequences. Sacral epidermal anomalies include dimples, tracts, lipomas, hemangiomas, and tufts of hair and may be associated with a neural tube defect, such as spina bifida. Epigastric mass; Epigastric swelling, mass. This study included 230 infants under 6-months-old (130 males and 100 females; mean age 52. The purpose of this study was to analyze unusual and complex dysraphism and propose a new classification based on clinicoradiological correlation and anatomical location. Tailbone pain often feels dull and achy in the area between the gluteal cleft and above the anus but can also become sharp in certain situations (e. alwaysanxiousmum. Boston Children’s Hospital. A simple sacral dimple, defined as a midline dimple, within the gluteal cleft and without associated cutaneous abnormalities, is a common finding and considered to be a. a 1. Single dimple. Otherwise, in the case of atypical sacral dimple, deviated gluteal cleft, or association of two specific cutaneous markers, we suggest to perform US. “High-risk” dimples are defined as those that are (1) deep; (2) larger than 0.