Multiple dimples were encountered. g. Respondents would obtain imaging in 57%, 89%, and 65% respectively. The 2024 edition of ICD-10-CM Q82. 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. 1. Takeaway. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. Sacral dimple newborn. This type of back dimple is directly superficial to the two sacroiliac joints, where the sacrum. 10 Albright,12 a neurosurgeon from Wisconsin, estimated a notably high A B. POA Exempt. A pilonidal cyst (also called pilonidal cyst disease, intergluteal pilonidal disease or pilonidal sinus) is a skin condition that happens in the crease of the buttocks — anywhere from the tailbone to the anus. We classified dimples at the initial consultation, not at the time of MRI. Among this group, 20% (46 of 235) had OSD. doi: 10. relevance of sacrococcygeal pits or dimples, which are very common (4. The fissure in the underlying bone is from the imperfect fusion of two halves of the jaw bone. Such{{configCtrl2. The frequency of the cleft chin varies widely among different populations. There is a necessity for detailed embryological knowledge for a better. e. Pregnancy was. About 3 to 8 percent of the population has a sacral dimple. Remove femur after distal mobilization and disarticulate hip posteriorly through the decubitus ulcer. Chin dimple. 6 - Congenital sacral dimple. There was no difference in the rate of OSD based on dimple location. hemangioma, telangiectasia Isolated midline dimple was the most common indication for imaging. ! 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 gluteal region is located at the back of the body, representing the transition point between the trunk and the lower limbs. The crease is nearly always present and usually not perfectly symmetrical. Sacral dimples. 2-7. assymetric gluteal cleft - basically, a crooked butt crack . Sacral Dimple. 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. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. A V-shaped crease (sacral triangle), which arises from the. (hypertrichosis, haemangioma, caudal appendage, deviated gluteal fold, discharging sinus, etc) > 5mm in diameter, situated above the natal cleft or > 25mm from anus. In patients with a sacral dimple, the location of the dim - J neurosurg Pediatr). Her skin was warm, dry, and pink, with a 3. tenderness. If it is, she would need surgery to have the the tethered cord snipped. Gonzalez et al. Now I’m freaking myself out because everything you see on google says tethered spinal cord. Introduction. This is the American ICD-10-CM version of Q82. Hyperglycemia, infection, toxic and ischemic insults have been implicated. We have been told our 6 week old son has a forked gluteal (naval) cleft or I y-shaped crease at the top of his button - Answered by a verified Pediatrician. hemangioma, telangiectasiaBy Perrine Juillion / October 25, 2019. 273 results found. My oldest has a “duplicated gluteal cleft” which is also a marker for spina bifida. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. Back dimples, including sacral and venus dimples, are indentations in the lower area of the back. Lagertha1. 5 cm of the anal verge, less than 0. His chromsome deletion also has tethered cord listed as a possible diagnosis. Showing 1-25: ICD-10-CM Diagnosis Code Q82. 8% of all children. Q82. As a result, no further investigation is needed for these simple dimples. doi: 10. 8. They're often found near the gluteal cleft, which is where pilonidal sinuses typically develop. Zywicke and Curtis J. little man has a duplicated gluteal cleft. 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 . Dimples can also occur higher up above the gluteal cleft. These anomalies occur in 4% of newborns 1 with fewer than half prompting medical concern. Figure 4. S. Basic Facts HAIR: The term “Pilonidal” technically means “nest of. This is not noticed when your child has on clothing. 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. 5%. Of our soft-tissue appendages, two were surrounded by patches of hypertrichosis. 5 cm from the anus. features of sacral agenesis: narrow hips, hypoplastic gluteal muscles, shallow intergluteal cleft; mild foot deformities and gait abnormalities; Pathology. The y shaped cleft was still there and didn't go away as pediatrician hoped. EQUIPMENT: Linear array transducers: EPIQ 7G L12-5. Single dimple. Hamoud et al. figure 1. Epub 2013 Aug 1. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped). He did great & slept through the whole thing. This can cause problems starting around age 2-3 (potty training age) is when parents start to see some signs. Epub 2013 Aug 1. 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. Isolated midline dimple was the most common indication for imaging. 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. 1136/arch dischild-2012-303564. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of. 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. 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. The goal of this procedure is to completely eliminate the gluteal cleft in the diseased area. Asymmetric or malformed Gluteal cleft . Answer: Gluteal cleft. 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. They did an ultrasound of his booty & spine when he was like a week old. 5 cm above the anus) and solitary. Pus or blood leaking from an opening in the skin. , hemangiomas. Dimples associated with a lumbosacral dorsal dermal sinus are usually midline dimples, located above the gluteal cleft, more than 2. Sacral and back dimples are congenital, which means you are born with them. 8. The patient’s mother had adequate prenatal care and a normal. 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. MeSH Code: D010864. 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. A full thickness skin flap is mobilized across the gluteal cleft to create an off-midline closure (Fig. The superior tip of the intergluteal. Atypical dimples may be located higher up on the back or off to the side. The finding of sacral dimples in newborns has been considered as a cutaneous sign for underlying Occult Spinal Dysraphism (OSD). A dermal sinus tract is a rare neural tube defect and is located above the gluteal cleft. 5). A sacral dimple is a small dimple or cleft at the base of the spinal cord. 2 mm (SD 19) above the coccyx (p = 0. 6% in normal newborns [1, 10,11,17]. midline without visible drainage. 8±42. Samir Shureih MD. All simple dimples were within the gluteal crease and had a visible, skin-covered base; all were <5 mm in size. Indications for lumbar spine sonography include multiple congenital anomalies placing an infant at increased risk, complicated sacral dimple (location above the gluteal crease, bottom of pit not seen, possible drainage from dimple, and presence of skin stigmata), softtissue mass suspected of being spina bifida occulta, determination of reason. Sacral dimples or “pits” result from incomplete closure of the neural tube during embryogenesis. Isolated midline dimple was the most common indication for imaging. Simple solitaire sacral dimples in asymptomatic neonates consisting of a single midline dimple that measures less than 5 mm in. g. 예전에는 잘 알려지지 않았지만. 5 × 1-cm lumbosacral skin appendage (black arrow), slightly to the left of midline, plus a y-shaped gluteal cleft. However, many children without spinal dysraphism also have these skin. A Guide to Pediatric Anesthesia. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. 4. Pilonidal sinus disease (PSD) is a common infection of the skin in the gluteal cleft, with a prevalence of 0. The midline fuses while coming together from both sides during this phase of development. Both are considered mild birth defects. 5 cm above the anus) and solitary. A sacral dimple is a small depression in the skin, located just above the buttocks. Nate has a wonky "Y" shaped butt crack and his second/third toes are slightly syndactyl (sp?). These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. 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. It rests between the iliac crests at the top of the gluteal cleft (often called the “butt crack”). Simple sacral dimples are present in 3–5% of newborns are not associated with increased risk of neural tube defects or dermal sinus tracts []. This can then lead to the subsequent formation of a subcutaneous abscess from a persistent folliculitis. Sacral dimples, also known as sacrococcygeal or coccy-geal dimples or pits, are the most common cutaneous. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. Case 1. Another back dimple appears closer to the crease of the buttocks, on the skin covering the sacrum. 2. Includes. A duplicated gluteal cleft associated with occult spinal dysraphism. He introduced the notion of “Gluteal Suspension System”. If the base could not be seen, this would be called a coccygeal pit. The y shaped gluteal cleft and a tuft of. Pain or tingling the legs or back; Curvature of the spine ANSWER: SACRAL DIMPLE. kdmahnke13. Simple sacral dimples require no further investigation whereas complex ones do. Stence, Todd C. It is the most common site of intra. In my experience, I often find that people start having. A pilonidal cyst can be extremely painful especially when sitting. 18 Although it has long been recognized that midline uncomplicated dimples located within the gluteal crease (so-called coccygeal pits) are unlikely to be associated with a tethering lesion, Gomi. More than 50% of OSDs are diagnosed when a dimple is noted, but obviously not all dimples are associated with an OSD. Figure 1. nervous system sacral dimples Pediatrics in. A duplicated gluteal cleft associated with occult spinal dysraphism. 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. In this condition, the patient do not have a sacral dimple on both or either side. defined the infragluteal fold as a result of gluteal ptosis secondary to sagging of the buttocks and redundant gluteal tissue [ 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. In person evaluation is needed. Those without OSD had a mean dimple position of 12. These cysts are usually caused by a skin infection and they often. The crooked gluteal fold seems to be caused by more fat on one side than the other. Five degrees of ptosis are described with rising sagging of tissues which define and length the IGF laterally. Download the BabyCentre app Opens a new window. A pilonidal sinus is a small hole or “tunnel” in the skin. Jun 18, 2023 at 1:42 PM. zoemcr. Sacral Dimples and Pits: Background. Access records and results, view and pay bills, request prescription renewals, and request appointments. The sacrum consists of five fused sacral vertebral and costal segments (numbered one-to-five) that form a central sacral body and paired. Deep dimples were noted in 1. 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. Open the PDF for in another window. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. She took some pictures and sent them to a neurosurgeon who said we. Pediatr Surg Int 30(5):545–548. I've never heard of such a thing before he was born. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. 3% of infants) and thought by some to be associated with risks of congenital dermal sinuses. This is the American ICD-10-CM version of Q82. My first has something a bit different - a 'forked gluteal cleft' (lol - it just means the crease of her bottom has a Y shape at the top). 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]. These bones are firmly connected by the pubic symphysis anteriorly and the sacrococcygeal and sacroiliac joints posteriorly. A pilonidal cyst may not cause symptoms. • The presence of more than one skin dimple anywhere along the neural axis is an indicator of the likely presence of OSD. Usually occur in combination of other masses, e. Soft-tissue caudal appendage plus bony caudal prominence in a male infant. 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%. In this condition, the patient do not have a sacral dimple on both or either side. 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. 5 cm) 4. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. 14) The dimples of Venus, a sign for the identification of the posterior superior iliac spine (PSIS) below the fascia. 14, 15, 22, 36 Most infants with sacral dimples that fall within the gluteal crease are healthy. It is shaped like an upside-down triangle and sits at the bottom of the spinal column, connecting it to the pelvis. JS O, Bhalla VK, Needham L, Sharma S, Pipkin WL, Hatley RM, Howell CG (2014) Müllerian-type, cutaneous ciliated cyst in the gluteal cleft mimicking a pilonidal cyst. 신생아 보조개 (Sacral Dimple) 은. 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. A fingertip placed on the dimple can be “rolled around” the tip of the coccyx. 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. • Spinal skin dimples and other cutaneous markings located outside of the sacrococcygeal region are associated most often with closed neural tube defects or OSD. 종종 척수 이상의 단서일 수 있어 중요 해요!In this section, we will focus on bilateral advancement flaps. Sacral dimples can be “typical” or “atypical”. 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. 4. 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. 8. 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. Imaging 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. Careful inspection of the natal cleft for dimples and symmetry may reveal a dimple below the top of the gluteal crease in 2% to 4% of normal newborns. A simple sacral dimple is: · No more than 2. 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. Figure 4. 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. 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%),. 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. Tabs. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. 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. Where is a gluteal cleft? There are several names for this area: natal cleft, gluteal crease, gluteal crevice. 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. Simple solitaire sacral dimples in asymptomatic neonates consisting of a single midline dimple that measures less than 5 mm in diameter, located no more than 25 mm above the anal opening, have an extremely low associated risk of spinal malformations. 2 mm (SD 19) above the coccyx (p = 0. 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. It is generally accepted that further evaluations via radiologic imaging and early neurosurgical referrals are required when atypical dimples exist. Its limits are (Fig. In some cases, a sacral dimple can be a sign of an underlying spinal problem. A coccygeal pit was. These tests may include: Ultrasound. 8. 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. From icd10data. of the dimple. . Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. They originate at the most caudal area of the. pressure on the ankles, heels and buttocks as too much pressure can tear the thin. Sacral Dimple. a birthmark in the area. Sacral dimples that are accompanied by a nearby tuft of hair, skin tag or certain types of skin discoloration are sometimes. B. Not Included Here. A sacral dimple can be a sign of a serious spinal problem in a newborn if the dimple is large or appears near a. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. Includes. Each referred participant was risk stratified based on specific physical exam findings. The y shaped gluteal cleft and a tuft of. 2). 8, 13 Associated skin anomalies such as hair tufts or vascular lesions may also be found. Larger lesions ("atypical dimples") and those above the gluteal cleft have been associated with spinal dysraphism. Code. 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. nervous system sacral dimples Pediatrics in Review Vol. Diaphragmatic hernia; shortened long bones; Y shaped gluteal cleft; abnormal facial appearance (hypotelorism, flattened nasal bridge) Autopsy: Midline. Both sexes are equally affected. z. Sometimes, sacral dimples are a sign of spina bifida occulta; however, many instances aren't related to spinal cord malformations. 2013 Oct;98(10):784-6. In a transverse plane, the bony landmarks of the two cornua are identified at the proximal end of the gluteal cleft (Fig. A duplicated gluteal cleft associated with occult spinal dysraphism. Monday she will see a neuro sergion for a physical exam. This can then lead to the subsequent formation of a subcutaneous. The gluteal cleft is just above the anus. 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. Bowel movements, penetrative sex, and orgasm can also be a source of aggravation for the tailbone. Position – within the gluteal fold or coccygeal position. About 3 to 8 percent of the population has a sacral dimple. Sacral dimples or pits are common. He has a y shaped gluteal cleft right above his bottom! Of course I am…Mid-line skin dimples - often called a 'Sacral Pit' • Tufts of hair • Visible hemangioma / skin discolo ration • Infection / abscess . An odor from draining pus. “Midline lumbosacral skin lesions (e. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). When they affect the lumbar and perineal area some cases can be associated with an occult spinal dysraphism. 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. Linear lesions in the intergluteal cleft are caused by moisture with or without a friction component and should be classified as intertriginous (between skin folds) dermatitis (inflammation of the skin). The skin may look inflamed, smooth, or scaly, and may feel itchy and uncomfortable. 6 - Congenital sacral dimple. 6 is a billable diagnosis code used to specify a medical diagnosis of congenital sacral dimple. Applicable To. Congenital sacral dimple. 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. nervous system sacral dimples Pediatrics in Review Vol. They represent a heterogeneous group ranging from mild clinical manifestations—going unnoticed or being discovered at clinical examination—to a causal. A lump of the lower back. B. 5 cm of the anus), and do not have an associated cutaneous abnormality [4,5,6]. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. not associated with other cutaneous stigmata of spinal dysraphism (e. 8% reported by another. Not Included Here. Q82. Sacral dimples can appear anywhere between the lower back and the top of the buttocks. Hypertrichosis. However, high, or large sacral dimples, or combined with other abnormalities should be imaged, starting with spinal US3. org While multiple studies (described below) have shown that ultrasound can be useful when a sacral dimple is identified, these studies do not differentiate between a true, rare sacral dimple (located over the sacrum above the rectal crease) and a common coccygeal pit (located over the top of the coccyx within the rectal crease). Associated Conditions. He had an ultrasound at a week old and it was negative. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Q76. Fig. Sex hormones act on sudoriferous glands and affect hair growth; other factors like sitting for. (B) Sever all knee ligaments. 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. <2. Low-risk findings included “simple dimple,” defined as a soft tissue depression appearing up to 2. ”Simple sacral dimples or pits (solitary dimple, < 5mm in diameter, situated in the. Sacral epidermal anomalies include dimples, tracts, lipomas, hemangiomas, and tufts of. • 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. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. Back pain or shooting pain in the legs. Back dimples — indentations on your lower back — are a fairly common cosmetic feature. • 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. [Billable] [POA Exempt] There's more to see -- the rest of this topic is available only to subscribers. Other perianal infectionsGluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. 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. Hey Ladies. 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. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. 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. 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. She said this could mean she has a tethered spinal cord. 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 patch, and dysplastic skin) in 31 (6%), several of the above. Dimples that may require further investigation are those that are large. Diagnosis. The bony pelvis (pelvic girdle) is composed of the two hip bones, the sacrum, and the coccyx. An approach to ultrasound investigation of sacral dimples is presented in . Bilateral gluteal tendinitis; Gluteal tendinitis of left hip; Left gluteal tendinitis; Tendinitis of bilateral gluteal tendons. It is present by birth in babies. Each referred participant was risk stratified based on specific physical exam findings. We should probably be reassured that it hasn’t been flagged with us! 1. 4). The following features of dimples are associated with OSD. Flattening of buttocks and loss of gluteal cleft in a child with sacral agenesis. Infants with a simple sacral dimple, with evidence of abnormal neurologic or orthopedic exam findings should be further evaluated F. 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. 90. Sacral dimples are more likely to be associated with OSD if they are above the gluteal cleft. They have no associated abnormalities (hairs, skin markings, etc. 5 cm from the anus. 6 - other international versions of ICD-10 Q82. See full list on mayoclinic. Sign in to MyChart. These dimples are found in 2-4% of children & usually of no significance. Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. 5 cm above the anus) and solitary. O'Neill, Danielle Gallegos, Alex Herron, Claire Palmer, Nicholas V. 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. She had no rashes. 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. above the gluteal cleft. 5 cm from anus. However, if referral is required please refer as soon as possible. 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. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging.