Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. Hankinson, C. These anomalies occur in 4% of newborns 1 with fewer than half prompting medical concern. A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris. Larger lesions ("atypical dimples") and those above the gluteal cleft have been associated with spinal dysraphism. No other skin changes are seen. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. A duplicated gluteal cleft associated with occult spinal dysraphism. Most coccygeal dimples are located near the midline, within or just above the gluteal crease (within 2. Position – within the gluteal fold or coccygeal position. Pilonidal sinus disease (PSD) is a common infection of the skin in the gluteal cleft, with a prevalence of 0. Sacral dimple newborn – a prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. It can be mistaken for other causes of low back pain. S. This anatomy is well depicted at imaging, and management is often dictated by what structures are involved. Sacral Dimple. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. From there they would recommend an MRI to see if her cord is tethered. O'Neill, Danielle Gallegos, Alex Herron, Claire Palmer, Nicholas V. 01 coding with all applicable Excludes 1 and Excludes 2 notes from the section level conveniently shown with each code. An approach to ultrasound investigation of sacral dimples is presented in . She said this could mean she has a tethered spinal cord. Base of dimple is visible. 01 [convert to ICD-9-CM] Pilonidal cyst with abscess. A dermal sinus tract is a rare neural tube defect and. 5 cm from anus · Less than 5 mm diameter · Localized in gluteal cleft Further workup needed No intervention needed Referral for MRI Further workup needed Age < 8 weeks? (more info) Yes Age < 8o weeks No Referring provider Age ≥ 8 weeks to order. Bowel movements, penetrative sex, and orgasm can also be a source of aggravation for the tailbone. It usually develops in the cleft of the buttocks where the buttocks separate. However, if referral is required please refer as soon as possible. 5 cm above the level of the anus with a relatively large ostium and an atypical appearance. More than 86% of spinal dysraphisms are associated with overlying cutaneous stigmata []. 2-7. 02 [convert to ICD-9-CM] Gluteal tendinitis, left hip. It covers the area from iliac crest from above to the gluteal fold below. Jun 18, 2023 at 1:42 PM. 5. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. These dimples are located at or near the tip of the coccyx within the gluteal cleft and are visible only when the buttocks is parted (Figure 1A). To differentiate these clinical mimics and to exclude DST in patients with sacral dimples, magnetic resonance imaging (MRI) is frequently indicated [ 5 ]. The examination is performed with high-frequency. Sacral dimple newborn. <2. Although frequently referred to as “sacral dimples,” the lesion is a whorl of skin that tracts to the coccyx . 5 cm from anus. 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. Stence, Todd C. The sacral prominence occurs where the last lumbar vertebra joins the sacrum. , deviated, split/duplicated) should prompt imaging regardless of the presence of a sacral dimple because of their rare association. 2 • The depth of the tract is also probably irrelevant. priate for dimples superior to the gluteal cleft (Fig. Each referred participant was risk stratified based on specific physical exam findings. The skin creases at the top of the cleft (white arrow) are on either side of a prominent, but otherwise normal, sacrum and coccyx. Similarly, the authors found high agreement that simple coccygeal dimples do not need imaging. Perianal candidal intertrigo presents as soreness and irritation with bright red erythema and satellite lesions extending into the natal cleft. CONTRAINDICATIONS: No absolute contraindications. Nine papers addressing routine spine ultrasounds for children with sacral dimples showed that 3. Most are blind ending, just above or within the crease of the buttocks, and do not require investigation or treatment. ” Which Sacral Dimples or Pits Should we Worry About? Complex sacral dimples or pits: Sacral dimples associated with other cutaneous findings (hypertrichosis, haemangioma, caudal appendage, deviated gluteal fold, discharging sinus, etc) > 5mm in diameter, situated above the natal cleft or > 25mm from anus. 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. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. But these lesions are limited to the gluteal cleft whereas a dermal sinus tract originates above the cleft and can interconnect with the spinal canal and dura mater. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. A sacral dimple is a small depression in the skin, located just above the buttocks. It is shaped like an upside-down triangle and sits at the bottom of the spinal column, connecting it to the pelvis. 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. The area seemed tender to the touch and was without spontaneous drainage. pressure on the ankles, heels and buttocks as too much pressure can tear the thin. doi: 10. Spinal dysraphism is a group of diverse conditions that have variable imaging patterns. 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 radiological investigation such as an MRI. However, many children without spinal dysraphism also have these skin. One of our neurosurgery RNs will gladly review and advise at no charge to help you determine next steps for your patient. basically, the top of his bum crack makes a y shape…Case description: We present a case of a 6-month-old male with a low-lying conus medullaris, lumbar syrinx, mildly abnormal urodynamic studies, and asymmetric utilization of his lower extremities observed during the evaluation of a Y-shaped gluteal cleft. 5 cm from anus 2 (1) Othera 14 (9) aSee Appendix A for other physical examination findings. g sitting, sit to stand, lying on back). There are several names for this area: natal cleft, gluteal crease, gluteal crevice. TheIn children, symptoms may include lesions, hairy patches, dimples, or fatty tumours on the lower back; foot and spinal deformities; weakness in the legs; low back pain; scoliosis; and incontinence. I've never heard of such a thing before he was born. EPIQ 5G eL18 -4. a. Most patients are asymptomatic and lack neurologic signs, and the condition is usually of no consequence. g. ICD 9 Code: 685. The hip line become curved in this. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. It is a congenital condition, meaning it is there when the baby is born. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . The following features of dimples are associated with OSD. 8. 6 may differ. Pregnancy was complicated by maternal obesity, mild intermittent asthma, hyperthyroidism, allergic rhinitis, anemia, and sickle cell trait. Dimples that are deep, large (> 0. In some instances, a sacral dimple is a sign of an underlying. A recent review article suggests that these lesions in isolation are benign and require no radiological evaluation. Although fistulas above the gluteal. Sacral Dimples and Pits: Background. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). Each hip bone consists of three fused bones: the ilium, ischium, and pubis. Although fistulas above the gluteal cleft may be associated with spinal dysraphism, coccygeal pits are benign and do not need imaging. I've never heard of such a thing before he was born. 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. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. Cute vs. Isolated midline dimple was the most common indication for imaging. 5 cm from the anal verge, dimples larger than 5 mm in diameter, or dimples associated with hair tuft, hemangioma, skin tag, or presence of sinus may indicate. Neonatal Sacral Findings Suggestive of Occult Spinal Dysraphism. Pediatr Surg Int 30(5):545–548. , lipomas, dimples, dermal sinuses, tails, hemangiomas, hypertrichosis) are cutaneous markers of spinal dysraphism. 14) The dimples of Venus, a sign for the identification of the posterior superior iliac spine (PSIS) below the fascia. 3. Anyway, my husband pointed it out again to the doctor at the 6 mo follow up. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped). 5 cm above the anus) and solitary. Closed spinal dysraphism (CSD) (also known as occult spinal dysraphism or spina bifida occulta) is characterized by failure of fusion of the vertebral bodies due to. does any of your baby have this? I will call our family doctor to have it assessed. This area is the groove between the buttocks that extends from just below the sacrum to the perineum, above the anus and is formed by the borders of the large buttock muscles called the gluteus maximus. Open neural tube defects are lesions in which brain, spinal cord, or spinal. They’re caused by short ligaments connecting your pelvis to your skin, but they have no. 14. a patch of hair by the dimple. Atypical dimples may be located higher up on the back or off to the side. 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. ! These lesions are more likely to be associated with discolourationThe procedure involves injection of medication through the sacral hiatus, which is an inverted U-shaped opening in the dorsal sacral surface lying at the apex of an equilateral triangle formed with the two posterior superior iliac spines. The only symptom of a sacral dimple is a generally shallow depression near the end of the tailbone and the top of the buttocks. 5 cm above the anus) and solitary. A duplicated gluteal cleft associated with occult spinal dysraphism. FACSsshureih@msn. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. 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. Although the literature suggests clinical consensus regarding some lumbosacral findings (simple dimples or slate gray macules), expert recommendations vary regarding the management of other findings (duplicated gluteal clefts or coccygeal or sacral hair). Sacrococcygeal dimples in the gluteal fold, also known as coccygeal pits, are observed in 2%–4% of. 4). Loss of bladder or bowel control that gets worse. A pilonidal cyst, also referred to as a pilonidal abscess, pilonidal sinus or sacrococcygeal fistula, is a cyst or abscess near or on the natal cleft of the buttocks that often contains hair and skin debris. Pilonidal Disease Fact Sheet A Pilonidal (abscess, cyst, sinus, dimple) is an abscess in the natal cleft (more commonly referred to as your butt crack) that tends to become infected and cause intense pain and drainage. 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 is found in the small of the back, near the tailbone, which. The nurse recognizes this as a sacral. with sacral dimples (Table 3) and found 41 cases (15. Code Tree. 4. Simple sacral dimples require no further investigation whereas complex ones do. Original poster's comments (2) 0. An approach to ultrasound investigation of sacral dimples is presented in . 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. alwaysanxiousmum. (1) (2) These defects, which result from. MeSH Code: D010864. The deep fat deposits located in the flanks, sacral region, hips, and lateral and medial thighs must be identified as they will be treated with liposuction [8, 9]. hemangioma, telangiectasiaBy Perrine Juillion / October 25, 2019. A 1-day-old girl is seen for routine care in the newborn nursery. 6% in normal newborns [1, 10,11,17]. Those with OSD had a mean dimple position of 15 mm (SD 11. However, if the sacral dimple is deep and large, greater than 0. Sacral dimples, also known as sacrococcygeal or coccy-geal dimples or pits, are the most common cutaneous. Nine papers addressing routine spine ultrasounds for children with sacral dimples showed that 3. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. Sacral Dimples Holly A. Excludes2: congenital sacral dimple parasacral dimple . The fissure in the underlying bone is from the imperfect fusion of two halves of the jaw bone. Zywicke and Curtis J. Sign in to MyChart. basically, the top of his bum crack makes a y shape when squished. sacral dimple, asymmetrical gluteal cleft, and presence of other congenital anomalies like multiple segmentation and fusion vertebral anomalies. The patient has an unusual sacral crease and sacral dimple. I have read a post on here where a mama's baby did have a y shaped crack, sacral dimple and a tethered cord and the baby will have surgery at 6 months. 8, 13 Associated skin anomalies such as hair tufts or vascular lesions may also be found. (or dimples) on either side of the medial sacral crest which correspond to the posterior superior iliac spines. 6 - Congenital sacral dimple. More than 50% of OSDs are diagnosed when a dimple is noted, but obviously not all dimples are associated with an OSD. Expand. My youngest has a sacral dimple but it is. I almost thought they just made that up!Download MyChart to connect with your care team. Zywicke et al. 8. Among this group, 20% (46 of 235) had OSD. However, the vertebral defects may occur in association with other more severe anomalies of the spinal cord and sacral structures, such as split spinal cord malformation or various cavitary defects of the spinal cord. The name comes from the sacrum, the bone at the end of the spine, over which the dimples are found. Congenital sacral dimple. Respondents differed on the type of imaging that they would perform, with 31% to 38% recommending. A coccygeal pit is a very low lying dimple with the pit pointing towards the coccygeal tip. 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. Those without OSD had a mean dimple position of 12. Original poster's comments (5) 3. Deep dimples. In general, no local anesthesia is applied to the skin or subcutaneous tissues. ”Simple sacral dimples or pits (solitary dimple, < 5mm in diameter, situated in the. there is a duplicated gluteal cleft there is more than one dimple the dimple lies outside the sacrococcygeal region there are any neurological abnormalities noted The above may be. Prompt and accurate diagnosis is important to determine the best plan of treatment. 2,4–6 Variations between practicing clinicians with respect to the management of. The patient has an unusual sacral crease and sacral dimple. Sacral dimples are considered simple if they are located within 2. On the other hand, "sacral dimples" are higher on the lower back, usually on both sides (not in the middle). 쉽게 촬영 가능하여 엄마들 사이에서 많이 알려졌어요. a. The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). Yes my son has that. Three had associated asymmetric or Y-shaped gluteal clefts. Clinicians may identify similar conditions, but details will differ that aid in differential diagnosis. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. 2. k. Venus dimples are two dimples that appear on the lower back, just above the gluteal cleft. A. 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%. If it is, she would need surgery to have the the tethered cord snipped. The sacral cornu, which flanks the rostral margin of the sacral hiatus on either side, acts as the surface. . 3 March 2011 111 The 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. 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. Tinea cruris is usually due to T. People can discuss. This study included 230 infants under 6-months-old (130 males and 100 females; mean age 52. He introduced the notion of “Gluteal Suspension System”. g. Most sacral dimples are harmless and don't require any treatment. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. horseshoe kidney, polyhydramnios, sacral dimple, VSD: MRI: CSF disorder: Enlarged cisterna magna (HP:0011427) Absent corpus callosum (HP:0001274) VSD, thickened. Pilonidal sinuses are characterised by natal cleft suppuration and are thought to initially result from a hair follicle infection. • 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. l. Lumbosacral dimples and coccygeal dimples (pit) of the midline spine are one of the most controversial areas in pediatric neurosurgery. Sacral dimples are relatively common, occurring in 2-4% of newborn infants. Patients with deep dimples were significantly more likely toThirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. Asymmetric or malformed Gluteal cleft . k. The code is exempt from present on admission (POA) reporting for inpatient. It's usually located just above the crease between the buttocks. The intergluteal cleft (a. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. The only significant finding in that area would be a sacral dimple that is deep and that might need investigating for a condition known as spina bifida occulta. Simple sacral dimples require no further investigation whereas complex ones do. These guidelines have therefore been prepared with a view to ensuringMy son who is 6 months old is scheduled for a MRI in June to check for a tethered cord. Boston Children’s Hospital. 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. PMID:Y shaped gluteal waiting for scan. Gluteal Region is the back and side of lateral half of pelvic region. INTRODUCTION. Standing or sitting for a long time or climbing stairs can make the pain worse. Duplicated Gluteal cleft. By Perrine Juillion / October 25, 2019. Posted 06-24-17. sacral dimples and other stigmata of spinal dysraphism. ICD 10 code for Other congenital malformations of spine, not associated with scoliosis. Almost always, if the dimple is within the gluteal crease, there is no underlying spinal abnormality and no investigation is necessary. Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory and motor problems and loss of bowel and bladder control emerge. However, if the sacral dimple is deep and large, greater than 0. Gluteal Muscles. 1 Atypical Sacral Dimple: Not in midline, not in sacrococcygeal region, >5 mm deep, >2. Sacral dimples are one of the commonest spinal cutaneous abnormalities seen in the newborn. These anomalies occur in 4% of newborns 1 with fewer than half prompting medical concern. Apr 24, 2016 at 7:40 PM. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. Typically, pilonidal cysts occur after puberty. Figure 14. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. We should probably be reassured that it hasn’t been flagged with us! 1. Sex hormones act on sudoriferous glands and affect hair growth; other factors like sitting for. The rotating of tissue causes the gluteal cleft to shift. A step-by-step drawing of the surgical process. , saddle numbness and tingling, or weakness in arms or legs) Neurogenic BBD (spinal anomalies, transverse myelitis, central nervous system. Bilateral gluteal tendinitis; Gluteal tendinitis of left hip; Left gluteal tendinitis; Tendinitis of bilateral gluteal tendons. ICD 9 Code: 685. The other synonyms of gluteal cleft are anal cleft, gluteal sulcus, natal cleft and intergluteal cleft. (hypertrichosis, haemangioma, caudal appendage, deviated gluteal fold, discharging sinus, etc) > 5mm in diameter, situated above the natal cleft or > 25mm from anus. It rests between the iliac crests at the top of the gluteal cleft (often called the “butt crack”). Gross anatomy. Multiple dimples were encountered. Single, deviated gluteal crease with dimple. Summary. She took some pictures and sent them to a neurosurgeon who said we. Incidence of FTF in patients with sacrococcygeal dimples. Figure 2. IU22 L12-5. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. Sacroiliitis can cause pain and stiffness in the buttocks or lower back, and the pain might go down one or both legs. 2, 3 Abnormal antenatal US scan of spinal column 4. 8. Caution: Not every dimple, opening or abscess in the sacral regions is pilonidal disease. Answer: Sacaral dimple. Feb 4, 2023 at 3:55 PM. assymetric gluteal cleft - basically, a crooked butt crack . These bones are firmly connected by the pubic symphysis anteriorly and the sacrococcygeal and sacroiliac joints posteriorly. nervous system sacral dimples Pediatrics in. We should probably be reassured that it hasn’t been flagged with us! 1. Sign in to MyChart. Sacral dimples can be “typical” or “atypical”. Figure 4. @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. This is the American ICD-10-CM version of Q82. Distance < 2. Not Included Here. The only significant finding in that area would be a sacral dimple that is deep and that might need investigating for a condition known as spina bifida occulta. toward the head) No other dermal abnormalities or masses. 8) above the coccyx. It is present by birth in babies. A sacral dimple is diagnosed with a physical exam, usually during a baby's first exam. Symptoms of Tethered Spinal Cord. Dimples that may require further investigation are those that are large. It’s usually just above the crease between the buttocks. Code. 신생아 보조개 (Sacral Dimple) 은. Some authors tried to propose a higher threshold score based on the five-point scoring system, however, it did. 5 cm; (3) located within the superior portion of the gluteal crease or above (greater than 2. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). Such{{configCtrl2. 정상 변이로 양성인 경우가 대부분이지만. Spinal dysraphism is a group of diverse conditions that have variable imaging patterns. 4 ). The thing is I also did notice during diaper changes there was a dimple there. The atypical type of lobster-claw deformity (U-shaped defect) which only involved the right hand of this infant. Case 1. The aim of this study was to determine the clinical. 8) GLUTEAL CLEFT DEVIATION • Minimal physiologic asymmetry to significant deviation with associated asymmetric glutes • Among the patients undergoing screening for OSD , upto 8% had asymmetric gluteal cleft deviation and 7% presented with Y shaped gluteal cleft • Unclear about the significance of an isolated deviated gluteal crease 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 an appt in because it's non urgent. 6 [convert to ICD-9-CM] Congenital sacral dimple. skin tags. Most people associate the word sinus with the nose, but sinuses can occur anywhere in the body. Arch Dis Child. g. It is present by birth in babies. Flattening of buttocks and loss of gluteal cleft in a child with sacral agenesis. 5 cm from the anus without associated visible drainage or hairy tuft. 21 A skin dimple is present on the flat portion of the sacrum well above the upper end of the gluteal cleft. Rozzelle. Dry skin, in general, tends to crack and can even become inflamed. not associated with other cutaneous stigmata of spinal dysraphism (e. Sacral dimples occur in the sacral area as small depressions or pits in the skin, most with a visible floor. Q82. Usually occur in combination of other masses, e. May be associated with VATER association, imperforate anus, cloacal extrophy and other urogenital abnormalities. 1136/arch dischild-2012-303564. POA Exempt. Nate has a wonky "Y" shaped butt crack and his second/third toes are slightly syndactyl (sp?). The bony pelvis (pelvic girdle) is composed of the two hip bones, the sacrum, and the coccyx. The patient’s mother had adequate prenatal care and a normal. The gluteal fat is allowed to appose and excess skin is excised to re-contour the natal cleft and allow a shallower closure away from the midline. 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. Multiple dimples were encountered. In women, the sacral dimples must be framed. Current data shows that a screening ultrasound is appropriate. 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 28 (5%), other isolated cutaneous stigmata (subcutaneous lipoma, vestigial tail, hairy. Figure 1. Since my little one was born, I find that the sacral dimple to the separation line of her left and right buttocks does not look in symmetry, sth like a "C" shaped. 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. In person evaluation is needed. @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. The gluteal region is located at the back of the body, representing the transition point between the trunk and the lower limbs. Based on the information provided, a possible diagnosis for this child may be a sacral dimple or pilonidal dimple with associated neurogenic bladder. For example, “The wound is locatedA sacral dimple, or pilonidal dimple, is a small hollow area or sinus present at birth and located just above the crease of the buttocks. z. Topics: congenital abnormality , cysts , magnetic resonance imaging , salmon patch , skin manifestations . Nevertheless, in some practices, imaging is routinely obtained on neonates with simple sacral dimples and/or deviated gluteal clefts with the indication of “rule out tethered cord. (B) Sever all knee ligaments. 6 is exempt from POA reporting ( Present On Admission). 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. 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. Q82. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of having a tethered cord. 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 mass). simple sacral dimple, defined as a midline dimple, within the gluteal cleft and without associated cutaneous abnormalities, is a common finding and. An odor from draining pus. Hey Ladies. Both sexes are equally affected. org.