5cm from the anal verge) Coccygeal pits (located within gluteal cleft, oriented caudally or straight down) Port Wine Stain or Telangiectases Intermediate Risk Category (Perform ultrasound if age <6 months or MRI if age ≥6 months)Code History. Figure 2. Among this group, 20% (46 of 235) had OSD. Each referred participant was risk stratified based on specific physical exam findings. In association with other OSD associated. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. Dimple is oriented straight down (i. He introduced the notion of “Gluteal Suspension System”. B. 5 cm, are positioned below the gluteal folds and have no other cutaneous features (dark hair, colour change) are innocent and do not require any further investigation. An approach to ultrasound investigation of sacral dimples is presented in . Subcutaneous lipomas. Figure 3. News & World Report A sacral dimple is a small, usually shallow indentation in the small of the back, just above or within the crease of the buttocks. Now I’m freaking myself out because everything you see on google says tethered spinal cord. It is present by birth in babies. It goes laterally up to a virtual line converging the anterior superior iliac spine to the anterior edge of higher trochanter and Medially goes up to mid-dorsal line and natal cleft. 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. A sacral dimple is defined as a midline dimple less than 5 mm in diameter and no further than 2. 5cm from anal verge, multiple dimples, Skin lesions and Associations (duplicate gluteal cleft,Had our first well check today and scheduled an ultrasound. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. Sacral dimples occur in the sacral area as small depressions or pits in the skin, most with a visible floor. Sacral dimples requiring spinal Ultrasound: • Asymmetrical intergluteal crease. caudal) not cephalically (i. This means that the butt crack will appear off-center. Sacral dimple ultrasound – sagittal ultrasound showing normal conus level and no underlying spinal dysraphism (red circle is approximate area of cutaneous sacral dimple)Gluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. A sacral dimple is a small dimple or cleft at the base of the spinal cord. If you have to split the glutei to see the dimple, then this is low-lying and less suspicious for dysraphism. They did an ultrasound of his booty & spine when he was like a week old. Screening for spinal dysraphisms in newborns with sacral dimples (2016) A. simple sacral dimple, defined as a midline dimple, within the gluteal cleft and without associated cutaneous abnormalities, is a common finding and. I never thought to bring it up to the doctor until recently when my mom said it’s not normal. Current data shows that a screening ultrasound is appropriate. Symptoms of an infected pilonidal cyst include: A pit near the top of the buttocks crease. 4. The gluteal muscles can be divided into 2 groups that are responsible for the main movements of the hip joint Hip joint The hip joint is a ball-and-socket joint formed by the head of the femur and the acetabulum of the pelvis. Pus or blood leaking from an opening in the skin. zoemcr. 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. Code. Prompt and accurate diagnosis is important to determine the best plan of treatment. More than one hole may develop, and often these are linked by tunnels under the skin. Simple sacral dimples require no further investigation whereas complex ones do. 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. 02 [convert to ICD-9-CM] Gluteal tendinitis, left hip. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Q76. One of our neurosurgery RNs will gladly review and advise at no charge to help you determine next steps for your patient. ICD 10 code for Other congenital malformations of spine, not associated with scoliosis. Pathology. 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. This study included 230 infants under 6-months-old (130 males and 100 females; mean age 52. 8. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. Jun 18, 2023 at 1:42 PM. 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. 8% reported by another. The hip line become curved in this. It is shaped like an upside-down triangle and sits at the bottom of the spinal column, connecting it to the pelvis. kdmahnke13. Clinicians may identify similar conditions, but details will differ that aid in differential diagnosis. Figure 4. Most are blind ending, just above or within the crease of the buttocks, and do not require investigation or treatment. <2. 예전에는 잘 알려지지 않았지만. I’ve noticed my baby has a Y shaped cleft on her bottom. Sacral Dimples and Pits: Background. Q82. See full list on mayoclinic. g sitting, sit to stand, lying on back). Code Tree. 2, 3 Abnormal antenatal US scan of spinal column 4. asymmetric gluteal cleft, lipoma, hemangioma, or sacral dimple suggestive of a congenital dermal sinus. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. a dimple on the chin. 14. Sacral dimple newborn – a prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. not so much: Pilonidal "dimples" are properly called "pits", are always in the midline in the gluteal cleft, and are where infection of the pilonidal cyst starts, as dislodged hairs can work themselves into these. 6 - Congenital sacral dimple. Two pilonidal cysts that have formed in the gluteal cleft of an adult man. with sacral dimples (Table 3) and found 41 cases (15. , hemangiomas. A pilonidal sinus is a small hole or “tunnel” in the skin. [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. 1136/arch dischild-2012-303564. Byun (Nov 2014) • Cutaneous coccygeal and sacral stigmas occur in 4. Simple coccygeal dimples are small (less than 5 mm in diameter) and shallow, with a visible base and straight orientation. 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. 21 Lipoma Hairy Patch (1) Hairy Patch (2). relevance of sacrococcygeal pits or dimples, which are very common (4. B. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). e. 4% of the 5166 patients had abnormal spine ultrasounds, compared with the 4. Rozzelle. About 3 to 8 percent of the population has a sacral dimple. 77 days. It covers the area from iliac crest from above to the gluteal fold below. 2 • The depth of the tract is also probably irrelevant. 쉽게 촬영 가능하여 엄마들 사이에서 많이 알려졌어요. Results: The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). sacral dimple, asymmetrical gluteal cleft, and presence of other congenital anomalies like multiple segmentation and fusion vertebral anomalies. To differentiate these clinical mimics and to exclude DST in patients with sacral dimples, magnetic resonance imaging (MRI) is frequently indicated [ 5 ]. Sometimes, sacral dimples are a sign of spina bifida occulta; however, many instances aren't related to spinal cord malformations. Asymmetric Y-shaped gluteal cleft that is moderately associated with spinal dysraphism except if present with other lesions. cases presented patients with a sacral dimple within the gluteal crease (case 7), flat hemangioma on the midline (case 8), and symmetric (Y-shaped) splaying of the inter-gluteal cleft (case 9) (Fig. Sometimes a/w sacral agenesis Reflects defective. Code. There was no difference in the rate of OSD based on dimple location. 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%. Applicable To. The gluteal cleft was asymmetrical. Rarely (7 cases according to Pediatr Rev 2011;32:109), they are associated with an occult spina bifida. Spine ultrasonography (USG) is an effective and safe screening tool for patients with a sacral dimple. 종종 척수 이상의 단서일 수 있어 중요 해요!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%. 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. Whe the skin lateral to the dimple is stretched, skin can be seen covering the entire dimpled area. alwaysanxiousmum. Sacral dimples that are. g. From there they would recommend an MRI to see if her cord is tethered. In contrast, sacral dimples, pits, or sinuses present within the intergluteal cleft are common benign lesions thought to occur in between 2% and 4% of newborn babies. Simple dimples are defined as midline depressions in the dermis that are less than 5 mm in diameter and within 2. 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. Some consider the term spina bifida occulta. Sacrococcygeal dimples in the gluteal fold, also known as coccygeal pits, are observed in 2%–4% of. Figure 2. Most patients are asymptomatic and lack neurologic signs, and the condition is usually of no consequence. I almost thought they just made that up! Download MyChart to connect with your care team. 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. 4,16,18,19 A simple sacral dimple is located in the midline, within the gluteal cleft, has a diameter less than 5 mm, and is less than 2. 13422, 105:8, (890-894), Online publication date: 1-Aug-2016. She took pictures and sent to neurosurgeon to have a look. It is present by birth in babies. 91 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. pilonidal cyst with abscess (L05. features of sacral agenesis: narrow hips, hypoplastic gluteal muscles, shallow intergluteal cleft; mild foot deformities and gait abnormalities; Pathology. 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% and 89% recommended imaging). 5 cm from the anus, midline in location, and without visible drainage or additional associated. 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. Babies with congenital hip dislocation can also have asymmetrical gluteal folds. 8% reported by another study for children without sacral dimples. nervous system sacral dimples Pediatrics in. Single dimple. Cases in which the ultrasound findings are either equivocal or confirm spinal dysraphism may require an MRI of the spine and referral to the spinal rehabilitation clinic. e. The decreased reflexes in the lower extremities and the presence of a dimple above the gluteal cleft are concerning for an underlying neurological issue, which can affect bladder function and. They originate at the most caudal area of the. com. 6 days). 4. 12), especially if any discharge is observed or reported. The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). Pilonidal sinus disease (PSD) is a common infection of the skin in the gluteal cleft, with a prevalence of 0. Apr 24, 2016 at 7:40 PM. A coccygeal pit is a very low lying dimple with the pit pointing towards the coccygeal tip. Sex hormones act on sudoriferous glands and affect hair growth; other factors like sitting for. Lumbosacral dimples and coccygeal dimples (pit) of the midline spine are one of the most controversial areas in pediatric neurosurgery. ICD-10-CM L05. 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). 5 cm of the anus and no association of other cutaneous stigmata. Tremors or spasms in the leg muscles. Sacral Dimple. 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. 4). a dimple larger or deeper than 5 millimeters (mm) discoloration. Access records and results, view and pay bills, request prescription renewals, and request appointments. It rests between the iliac crests at the top of the gluteal cleft (often called the “butt crack”). The most common MSS lesions were “simple dimple” (125 infants), defined as a soft tissue depression ≤25 mm above the anus (regardless of size or depth), and deviated gluteal fold (DGF; 53 infants), defined as any abnormal gluteal fold (including bifid or split gluteal cleft) without an underlying mass. The patient has an unusual sacral crease and sacral dimple. If the base could not be seen, this would be called a coccygeal pit. Simple sacral dimples require no further investigation whereas complex ones do. A deviated or duplicated gluteal cleft should raise concern for OSD, whether or not a dimple is present. 6 may differ. A sacral dimple is a small indentation (dent) in the lower back, near the crease of the buttocks. Answer: Sacaral dimple. Sacral dimples. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. In contrast, sacral dimples that are deep and large (greater than 0. A pilonidal cyst may not cause symptoms. {{configCtrl2. Longitudinal grayscale ultrasound image demonstrates mild dilation (arrow) of the most caudal aspect of the central canal, immediately cranial to the conus medullaris. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. Conclusion. hairy tuft, rudimentary tail, hemangioma)E. Respondents differed on the type of imaging that they would perform, with 31% to 38% recommending. “Midline lumbosacral skin lesions (e. Pregnancy was. Such{{configCtrl2. All simple dimples were within the gluteal crease and had a visible, skin-covered base; all were <5 mm in size. She had no rashes. < 5 mm diameter. To date, the association with KS and closed NTD or tethered cord. 32 No. The shape from dimple to gluteal crease resembles an inverted exclamation mark (Fig. Similarly, the authors found high agreement that simple coccygeal dimples do not need imaging. A dermal sinus tract is a rare neural tube defect and. A 1-day-old girl is seen for routine care in the newborn nursery. sacral dimples and other stigmata of spinal dysraphism. ManagementSimple solitary dimples located within the gluteal cleft without evidence of drainage do not warrant further investigation. February 24, 2019 ·. There are several names for this area: natal cleft, gluteal crease, gluteal crevice. I've never heard of such a thing before he was born. 5 cm from the anus. Sacral dimples which have a clearly visualised base with a width of < 0. These bones are firmly connected by the pubic symphysis anteriorly and the sacrococcygeal and sacroiliac joints posteriorly. z. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 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. When imaging was recommended, there was preference for spinal MRI in most cases (67%). A full thickness skin flap is mobilized across the gluteal cleft to create an off-midline closure (Fig. Dimples that may require further investigation are those that are large. Fig. hemangioma at site of dimple and spreading to anus. My oldest has a 'forked gluteal cleft' (the top of her bottom is shaped like a Y) which can be a sign of a tethered cord, but she doesn't have it and I was told when she was a baby (and I was worried) that thousands of babies have bottoms like this and nearly 100% them are absolutely fine. 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. There are no differences reported among ethnic groups. Spinal dysraphisms (SDs) are congenital malformations of the spinal cord, determined by derangement in the complex cascade of embryologic events involved in spinal development. 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. Isolated midline dimple was the most common indication for imaging. 5% of 200. 6 became effective on October 1, 2023. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. 8 may differ. 3). little man has a duplicated gluteal cleft. Coccygeal dimples, increased lumbosacral and/or coccygeal hair, deviations and/or duplications of the gluteal crease, and lumbosacral slate-grey patches are common in healthy newborns and vary by. Scientists don’t know for sure what causes sacral dimples, but it may be genetic. 5 cm of the anus. e. hairy tuft, rudimentary tail, hemangioma) E. g. 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. Sacral dimples are one of the commonest spinal cutaneous abnormalities seen in the newborn. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. In person evaluation is needed. May be associated with VATER association, imperforate anus, cloacal extrophy and other urogenital abnormalities. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. A recent review article suggests that these lesions in isolation are benign and require no radiological evaluation. " by Holly A. 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. Zywicke and Curtis J. (A) Incision from the gluteal cleft to popliteal fossa and guillotine distal shank amputation. 5 cm from the anus. Care was taken to place the first limb in the gluteal cleft and along the gluteal fold, mirrored by the opposing flap (Figs. Each referred participant was risk stratified based on specific physical exam findings. Incidence of FTF in patients with sacrococcygeal dimples. little man has a duplicated gluteal cleft. 8. More than 86% of spinal dysraphisms are associated with overlying cutaneous stigmata []. A lump of the lower back. Zywicke and Curtis J. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. The infant should be referred for an outpatient ultrasound if two or more are present 2:-Multiple dimples >5 mm diameter; Base of dimple is not visible, despite thorough examination by a. and occult spinal dysraphism are suspected when a cutaneous marker overlies the spine of a newborn and occur within the gluteal cleft without any skin markers. 28 The most commonly used criteria for defining simple dimples are a small size (ie, <5 mm) with a midline placement within 2. S. abnormalities of 2nd toe on both feet. Cutaneous hemangiomas are the most frequent benign tumors in children. The purpose of this study was to analyze unusual and complex dysraphism and propose a new classification based on clinicoradiological correlation and anatomical location. Summary. A comprehensive review of 200 patients with spinal dysraphism found that 102 had a cutaneous sign. Almost always, if the dimple is within the gluteal crease, there is no underlying spinal abnormality and no investigation is necessary. The frequency of the cleft chin varies widely among different populations. Duplicated Gluteal cleft. • Spinal skin dimples and other cutaneous markings located outside of the sacrococcygeal region are associated most often with closed neural tube defects or OSD. a 1. 6 became effective on October 1, 2021. The sacrum is an irregularly-shaped bone, shaped roughly like an inverted triangle, with its base superior and apex inferior. 2-7. 신생아 보조개 (Sacral Dimple) 은. , hemangiomas. However, if the sacral dimple is deep and large, greater than 0. 2013 Oct;98(10):784-6. g. The following features of dimples are associated with OSD. 6 - other international versions of ICD-10 Q82. Bilateral gluteal tendinitis; Gluteal tendinitis of left hip; Left gluteal tendinitis; Tendinitis of bilateral gluteal tendons. My oldest has a “duplicated gluteal cleft” which is also a marker for spina bifida. 9. 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. Both are considered mild birth defects. ICD-10-CM Diagnosis Code L05. Remove the tibia and fibula. A sacral dimple is a small dimple or cleft at the base of the spinal cord. buttocks 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, so named because it forms the visible border between the external rounded protrusions of the. The 2022 edition of ICD-10-CM Q82. For questions about a sacral dimple, deviated or Y’d gluteal cleft or other concern related to tethered cord, send a message and optional photo to neurosurgerybabies@seattlechildrens. does any of your baby have this? I will call our family doctor to have it assessed. There was no difference in the rate of OSD based on dimple location. RESULTS. gluteal cleft / natal cleft / cluneal cleft / butt crack) is the posterior deep midline groove in the gluteal region. 89. ANSWER: SACRAL DIMPLE The patient has an unusual sacral crease and sacral dimple. Clinical pearl: Gluteal cleft anomalies (e. Larger lesions ("atypical dimples") and those above the gluteal cleft have been associated with spinal dysraphism. 2% of newborn babies. ICD 9 Code: 685. above the gluteal cleft. 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. toward the head) No other dermal abnormalities or masses. My youngest has a sacral dimple but it is. In some people the midline fusion is incomplete leaving people with a dimple, pilonidal cyst or in its worst form spina bifida. 6% in general population and upto 45% of evaluation for SD • Size ,location in relation to anus, depth of the pit, concurrent presentation with other. Both sexes are equally affected. Although fistulas above the gluteal cleft may be associated with spinal dysraphism, coccygeal pits are benign and do not need imaging. @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. However, high, or large sacral dimples, or combined with other abnormalities should be imaged, starting with spinal US3. Neonatal Sacral Findings Suggestive of Occult Spinal Dysraphism. 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 2024 edition of ICD-10-CM Q82. Associated Conditions. Original poster's comments (2) 0. Figure 4. Stence, Todd C. In women, the sacral dimples must be framed. Physical examination findings that prompted a spinal ultrasound included isolated deep sacral dimple (34%); deep sacral dimple in association with other cutaneous findings, including hypertrichosis, duplicated gluteal cleft, or hemangioma (3%); a. Sacral and back dimples are congenital, which means you are born with them. Among this group, 20% (46 of 235) had OSD. A pilonidal cyst can be extremely painful especially when sitting. 7% in the general population, more commonly affecting males (male to female ratio: 4:1) between the ages of 15 and 38 years [1-4]. Figure 1 shows the number of patients within each of these groups who did and. Perianal candidal intertrigo presents as soreness and irritation with bright red erythema and satellite lesions extending into the natal cleft. She had no dimples or sacral tuft. 4 ). Loss of bladder or bowel control that gets worse. Sacral dimples can be “typical” or “atypical”. It is curved with an anterior concavity and posterior convexity. 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. He also said that sacral dimples are one of the things they check on newborns in the hospital so if it had been a concern, we probably would’ve already heard about it. 2,4–6 Variations between practicing clinicians with respect to the management of. On the other hand, "sacral dimples" are higher on the lower back, usually on both sides (not in the middle). The skin may look inflamed, smooth, or scaly, and may feel itchy and uncomfortable. 6% in normal newborns [1, 10,11,17]. PMID: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%. 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. He had an ultrasound at a week old and it was negative. Albert G (2016) Spine ultrasounds should not be routinely performed for patients with simple sacral dimples, Acta Paediatrica, 10. 14, 15, 22, 36 Most infants with sacral dimples that fall within the gluteal crease are healthy. Figure 1. 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. midline without visible drainage. 3,. 0): 602 Cellulitis. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. [Wilson, 2016] Should be overlying the sacral bone or towards the gluteal cleft. 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. . ICD-10-CM Diagnosis Code R19. The doc looked at their butt cracks and my daughter's has a crooked crease right at the top. a. Those without OSD had a mean dimple position of 12. 5 cm from the anus) 2. Sacral dimples or pits are common. horseshoe kidney, polyhydramnios, sacral dimple, VSD: MRI: CSF disorder: Enlarged cisterna magna (HP:0011427) Absent corpus callosum (HP:0001274) VSD, thickened. Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory and motor problems and loss of bowel and bladder control emerge. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. However, many children without spinal dysraphism also have these skin. Whe the skin lateral to the dimple is stretched, skin can be seen covering the entire dimpled area. Multiple dimples were encountered. However, if referral is required please refer as soon as possible. Sacral and gluteal pressure wounds are a common problem in elderly and critically ill patients. Pain.