Sometimes called the Cleft procedure, this surgery removes all the skin covering the involved area. Gluteal Muscles. org. caudal) not cephalically (i. Subcutaneous lipomas. e. [Wilson, 2016] Should be. This area is the groove between the buttocks that. Most sacral dimples do not cause any health issues. A sacral dimple. Back dimples — indentations on your lower back — are a fairly common cosmetic feature. (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. 5 cm above the anus) and solitary. 4. Simple solitaire sacral dimples in asymptomatic neonates consisting of a single midline dimple that measures less than 5 mm in. These are referred to as duplicated or asymmetric or Y-shaped clefts or creases (Fig. [Wu, 2020] Have been associated with Closed Neural Tube Defects. But if it's infected, the skin around the cyst may be swollen and painful. a 1. a. Results: The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). Soft-tissue caudal appendage plus bony caudal prominence in a male infant. Corbett Wilkinson, Michael H. The cystic mass extended into a dilation of the central canal due to. More than 50% of OSDs are diagnosed when a dimple is noted, but obviously not all dimples are associated with an OSD. Most coccygeal dimples are located near the midline, within or just above the gluteal crease (within 2. Her skin was warm, dry, and pink, with a 3. A simple sacral dimple is defined as a solitary dimple less than 5 mm in diameter and less than 2. 4 ). All simple dimples were within the gluteal crease and had a visible, skin-covered base; all were <5 mm in size. Has anyone had any expierence with this ? Thanks x. Sacral dimples or pits are common. 2013 Oct;98(10):784-6. They do not. In this condition, the patient do not have a sacral dimple on both or either side. 5 cm from the anal verge), or associated with other cutaneous markers. Introduction. The Dr said its not attached & not to worry. Sometimes, sacral dimples are a sign of spina bifida occulta; however, many instances aren't related to spinal cord malformations. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. The patient was born at 40 weeks and 1 day of gestation to a 21-year-old gravida 2 now para 2 mother by vaginal delivery. gluteal cleft / natal cleft / cluneal cleft / butt crack) is the posterior deep midline groove in the gluteal region. 5 cm of the anus and no association of other cutaneous stigmata. The gluteal region is located at the back of the body, representing the transition point between the trunk and the lower limbs. This is the American ICD-10-CM version of Q82. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. May be associated with VATER association, imperforate anus, cloacal extrophy and other urogenital abnormalities. Pregnancy was. 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. hemangioma at site of dimple and spreading to anus. From there they would recommend an MRI to see if her cord is tethered. 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. 4. Includes. 21 Lipoma Hairy Patch (1) Hairy Patch (2). O'Neill, Danielle Gallegos, Alex Herron, Claire Palmer, Nicholas V. 5 cm above the anus) and solitary. The 2024 edition of ICD-10-CM Q82. Code. It is a congenital. Pregnancy was complicated by maternal obesity, mild intermittent asthma, hyperthyroidism, allergic rhinitis, anemia, and sickle cell trait. metaDescription()}}Simple Sacral Dimple All 3 criteria must be met. 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. Pediatr Surg Int 30(5):545–548. 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. track my baby. A pilonidal sinus is a small hole or “tunnel” in the skin. In some instances, a sacral dimple is a sign of an underlying. Figure 1. Dimples associated with a lumbosacral dorsal dermal sinus are usually midline dimples, located above the gluteal cleft, more than 2. These bilateral lines create a desirable sacral diamond on the patient’s lower back, which mimics the rhomboid area of Michaelis. Sacral dimples. 01); pilonidal cyst without abscess (L05. 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. 8. 8% to 7. 32 No. a. 5 cm above the anus) and solitary. 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. Twenty-seven patients had a low-lying spinal cord, and only one patient was suspected of having a tethered cord. The following features of dimples are associated with OSD. Evaluation for potential OSD usually. To differentiate these clinical mimics and to exclude DST in patients with sacral dimples, magnetic resonance imaging (MRI) is frequently indicated [ 5 ]. Figure 4. The two major types of spinal dysraphism are based on the appearance, i. Tabs. - Deviated or bifid (Y) gluteal cleft - Hemangioma - Caudal appendage - Dermal sinus tract (Possible marker of tethered cord syndrome) WF16240-12. Open the PDF for in another window. On the other hand, "sacral dimples" are higher on the lower back, usually on both sides (not in the middle). The term pilonidal cyst comes from the Latin words, “pilus” (hair) and “nidus” (nest). S. 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. 8% reported by another. Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory and motor problems and loss of bowel and bladder control. Original poster's comments (5) 3. EQUIPMENT: Linear array transducers: EPIQ 7G L12-5. In larger individuals the sacral prominence may not be palpable. Most sacral dimples are harmless and don't require any treatment. 2 months at imaging were included in the study. Screening for spinal dysraphisms in newborns with sacral dimples (2016) A. Not Included Here. It is found in the small of the back, near the tailbone, which is also known as the sacrum. There is a necessity for detailed embryological knowledge for a better. The sacral cornu, which flanks the rostral margin of the sacral hiatus on either side, acts as the surface. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. The y shaped cleft was still there and didn't go away as pediatrician hoped. 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. 49. Bowel movements, penetrative sex, and orgasm can also be a source of aggravation for the tailbone. nervous system sacral dimples Pediatrics in Review Vol. Coccydynia is a common condition that is known to be difficult to evaluate and treat. What is the ICD-10 code for sacral dimple?. Simple Sacral Dimple All 3 criteria must be met. 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. A duplicated gluteal cleft associated with occult spinal dysraphism. An approach to ultrasound investigation of sacral dimples is presented in . (b) X-ray showed absent sacral elements. Sacral dimple newborn – a prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. C. Bilateral gluteal tendinitis; Gluteal tendinitis of left hip; Left gluteal tendinitis; Tendinitis of bilateral gluteal tendons. Pilonidal sinuses are characterized by natal cleft suppuration and are thought to initially result from a hair follicle infection. , aperta (open) if the. Some authors tried to propose a higher threshold score based on the five-point scoring system, however, it did. Zywicke and Curtis J. Showing 1-25: ICD-10-CM Diagnosis Code Q82. If it is readily visible on the back, above the upper gluteal limit, then the dimple is suspicious. little man has a duplicated gluteal cleft. CONTRAINDICATIONS: No absolute contraindications. 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. Lagertha1. Basic Facts HAIR: The term “Pilonidal” technically means “nest of. Incidence of FTF in patients with sacrococcygeal dimples. 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. A pilonidal cyst is a cyst-like structure that develops in the upper portion of the crease between the buttocks. He underwent elective spinal cord detethering via the safe and effective, minimally. Jun 18, 2023 at 1:42 PM. Sacral dimples or pits are common. Each referred participant was risk stratified based on specific physical exam findings. hemangioma, telangiectasiaBy Perrine Juillion / October 25, 2019. (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. Epigastric mass; Epigastric swelling, mass. 4,17 Other criteria for an atypical dimple include deep dimple, 12,13 dimples located cranially to the gluteal. Yes my son has that. Rozzelle. 01 coding with all applicable Excludes 1 and Excludes 2 notes from the section level conveniently shown with each code. 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. 5. g. 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). 8. 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. Pathology. 7) LUMBO SACRAL DIMPLES AND COCCYGEAL DIMPLES (PIT) • aka Sacral dimples; It’s a Whorl of skin that tracts to the coccyx • Most common minor malformations ; 4. 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. 5 cm in diameter, and are not associated with any other cutaneous abnormalities (Figs. 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. 6 [convert to ICD-9-CM] Congenital sacral dimple. The hip line become curved in this. Cute vs. A simple sacral dimple is: · No more than 2. Sacral dimples that are. These cysts are usually caused by a skin infection and they often. A crooked crease between the buttocks. Remove the tibia and fibula. The skin may look inflamed, smooth, or scaly, and may feel itchy and uncomfortable. Asymmetric or malformed Gluteal cleft . 6% in normal newborns [1, 10,11,17]. Respondents would obtain imaging in 57%, 89%, and 65% respectively. Sacral dimples occur in the sacral area as small depressions or pits in the skin, most with a visible floor. Spinal dysraphisms (SDs) are congenital malformations of the spinal cord, determined by derangement in the complex cascade of embryologic events involved in spinal development. Definition. Each referred participant was risk stratified based on specific physical exam findings. The y shaped gluteal cleft and a tuft of. Q82. Photographs of commonly noted lumbosacral cutaneous physical examination findings. Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory and motor problems and loss of bowel and bladder control emerge. Expand. Case 1. 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 duplicated gluteal cleft associated with occult spinal dysraphism. 초음파 검사가 늘어나고 MRI도 상대적으로. Simple sacral dimples require no further investigation whereas complex ones do. Most of the abnormal findings in patients with sacral dimples were of no clinical significance. A prototypical benign sacral dimple that is located within the gluteal cleft (less than 2. Diagnosis. A duplicated gluteal cleft associated with occult spinal dysraphism. POA Exempt. 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. 4%-15. Median longitudinal scan of the sacral region showing the round shape of a coccyx soma (C) and the rectangular shape of the sacral somas. 89. Q82. In most cases, pilonidal dimples are benign and may just be accompanied by increased hair growth in the area. The area seemed tender to the touch and was without spontaneous drainage. 2, 3 If you have to split the glutei to see the dimple, then this is low-lying and less suspicious for dysraphism. a moment of education from surgication [Music] a sacral dimple classically is a little hole or a little pit at the very bottom of the spine it's a little bit of a misnomer because the sacral dimples that concern neurosurgeons are actually in the lumbar spine and are lumbar dimples rather than sacral dimples most sacral dimples are little indentations in the. Indications for imaging included isolated dimple in 235 patients (45%), asymmetrically deviated gluteal cleft in 43 (8%), symmetrically deviated (Y-shaped). Brent R. 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. midline without visible drainage. The atypical type of lobster-claw deformity (U-shaped defect) which only involved the right hand of this infant. Pain. Nine papers addressing routine spine ultrasounds for children with sacral dimples showed that 3. 신생아 보조개 (Sacral Dimple) 은. 8. 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 my experience, I often find that people start having. Dry skin, in general, tends to crack and can even become inflamed. 5 × 1-cm lumbosacral skin appendage (black arrow), slightly to the left of midline, plus a y-shaped gluteal cleft. 12), especially if any discharge is observed or reported. doi: 10. If the sacral dimple is large or appears with a nearby tuft of hair, skin tag or lump, or certain types of skin discoloration, your health care provider may suggest imaging tests to check for spinal cord problems. Spinal dysraphism is a group of diverse conditions that have variable imaging patterns. They're often found near the gluteal cleft, which is where pilonidal sinuses typically develop. S. Although fistulas above the gluteal cleft may be associated with spinal dysraphism, coccygeal pits are benign and do not need imaging. 8) above the coccyx. 6 may differ. 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. 2 and. 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-. This can then lead to the subsequent formation of a subcutaneous. Data were analyzed on 151 newborns; average age at the time of USG was 1. A fingertip placed on the dimple can be “rolled around” the tip of the coccyx. Single, deviated gluteal crease with dimple. Some consider the term spina bifida occulta. Figure 1. The name comes from the sacrum, the bone at the end of the spine, over which the dimples are found. 3 answers / Last post: 12/07/2018 at 8:49 pm. Sacral Dimples Holly A. The upper part of the neural tube forms the forebrain, midbrain and hindbrain. 8% reported by another. In a transverse plane, the bony landmarks of the two cornua are identified at the proximal end of the gluteal cleft (Fig. MeSH Code: D010864. 8% of all children. Among this group, 20% (46 of 235) had OSD. relevance of sacrococcygeal pits or dimples, which are very common (4. ICD-10-CM Diagnosis Code R19. Hair can then enter the abscess cavity and provoke a foreign body tissue reaction. Longitudinal grayscale. Subcutaneous lipomas. Posted 06-24-17. The hip joint is the most stable joint in the body and is supported by a very strong capsule and several. 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. simple sacral dimple, defined as a midline dimple, within the gluteal cleft and without associated cutaneous abnormalities, is a common finding and. little man has a duplicated gluteal cleft. Symptoms of Tethered Spinal Cord. symmetrically deviated (Y-shaped) gluteal cleft in 38 (7%), hemangioma in 28 (5%), other isolated cutaneous stigmata. Musculoskeletal examination revealed active movement of all limbs. 종종 척수 이상의 단서일 수 있어 중요 해요!In this section, we will focus on bilateral advancement flaps. Q82. a birthmark in the area. Sacral Dimple. Pathology. My oldest has a “duplicated gluteal cleft” which is also a marker for spina bifida. 2. Two pilonidal cysts that have formed in the gluteal cleft of an adult man. Code. 4. Doctors usually use ultrasound to find out if the dimple is. No other skin changes are seen. 5 cm from anus 2 (1) Othera 14 (9) aSee Appendix A for other physical examination findings. 4). There was no difference in the rate of OSD based on dimple location. Not Included Here. Neural tube defects are among the most common forms of birth defect, affecting 1 in every 1,000 pregnancies. A V-shaped crease (sacral triangle), which arises from the. 3). In general, no local anesthesia is applied to the skin or subcutaneous tissues. (B) Sever all knee ligaments. Sign in to MyChart. alwaysanxiousmum. 5 cm above the anus) and solitary. 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. May 6, 2021 at 5:44 AM. Sacral dimples, also known as sacrococcygeal or coccy-geal dimples or pits, are the most common cutaneous. 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. 5 cm of the anus without any associated abnormal masses or skin lesions. The skin creases at the top of the cleft (white arrow) are on either side of a prominent, but otherwise normal, sacrum and coccyx. Isolated midline dimple was the most common indication for imaging. Simple sacral dimples have the following features 1: <5 mm in diameter <2. In contrast, sacral dimples that are deep and large (greater than 0. Rarely (7 cases according to Pediatr Rev 2011;32:109), they are associated with an occult spina bifida. They originate at the most caudal area of the. A sacral dimple is a small dimple or cleft at the base of the spinal cord. Those with OSD had a mean dimple position of 15 mm (SD 11. The rotating of tissue causes the gluteal cleft to shift. The aim of this study was to determine the clinical. 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). Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Q76. This is the American ICD-10-CM version of Q82. Clinical pearl: Gluteal cleft anomalies (e. The patient’s mother had adequate prenatal care and a normal. Babies with congenital hip dislocation can also have asymmetrical gluteal folds. Results. Although fistulas above the gluteal. 5 cm), fall within the superior portion or above the gluteal crease (> 2. 2,4–6 Variations between practicing clinicians with respect to the management of. Although frequently referred to as “sacral dimples,” the lesion is a whorl of skin that tracts to the coccyx . The sacral dimple is congenital, meaning that it is present when an infant is born. Respondents differed on the type of imaging that they would perform, with 31% to 38% recommending. Similarly, the authors found high agreement that simple coccygeal dimples do not need imaging. Sacrococcygeal dimples in the gluteal fold, also known as coccygeal pits, are observed in 2%–4% of. 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. 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. 3. Whe the skin lateral to the dimple is stretched, skin can be seen covering the entire dimpled area. 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). 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. He did great & slept through the whole thing. 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. above the gluteal cleft. com. The depth of gluteal cleft varies and depend upon the developed gluteal muscles. 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. 6 may differ. toward the head) No other dermal abnormalities or masses. 5-cm diameter erythematous indurated raised area with fluctuance superior to the gluteal cleft at the base of the lumbar spine (Figure 1). of the dimple. It's usually located just above the crease between the buttocks. 3 • Retrospective study of 5,440 neonates found that only 0. Sometimes a/w sacral agenesis Reflects defective. When imaging was recommended, there was preference for spinal MRI in most cases (67%). Boston Children’s Hospital. 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. More than one hole may develop, and often these are linked by tunnels under the skin. 3. Dimples can also occur higher up above the gluteal cleft. Thirty-one infants with a sacral dimple had an echogenic filum terminale, and 57 children had a filar cyst. She had no dimples or sacral tuft. ICD-10-CM L05. Stence, Todd C. An approach to ultrasound investigation of sacral dimples is presented in . 6 is exempt from POA reporting ( Present On Admission). The tests listed below will help you indicate an innocent sacral dimple: Markers of Spinal Dysraphism UCSF Pediatric Brain Center(a) Transient dilation of the central canal in a 2-week-old male with a sacral dimple. We should probably be reassured that it hasn’t been flagged with us! 1. Access records and results, view and pay bills, request prescription renewals, and request appointments. Topics: congenital abnormality , cysts , magnetic resonance imaging , salmon patch , skin manifestations . A sacral dimple is a small dimple or cleft at the base of the spinal cord. The nurse recognizes this as a sacral. At her check up her doctor noticed that she has a y shaped gluteal crease. 초음파 검사가 늘어나고 MRI도 상대적으로. Pilonidal cysts can range from abscesses — painful collections of pus — to sinuses, and lead to persistent bloody drainage. Pilonidal sinuses are characterised by natal cleft suppuration and are thought to initially result from a hair follicle infection. Both sexes are equally affected. Sacral Dimple. Access records and results, view and pay bills, request prescription renewals, and request appointments. Sacral Dimple. The intergluteal cleft is a surface anatomy landmark of the pelvis and lower limb. A sacral dimple is found in the gluteal cleft and you will need to separate the glutes to find it. Base of dimple is visible. Fig. hemangioma, telangiectasia Isolated midline dimple was the most common indication for imaging. Q82. For instance, a congenital sacral dimple or parasacral dimple occurs in newborns at the same anatomic site but does not involve embedded hair or infection. Other perianal infectionsGluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. 6 - other international versions of ICD-10 Q82. Spinal dysraphism encompasses congenital problems that result in an abnormal bony formation of the spine and/or the spinal cord. 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. 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. There was no difference in the rate of OSD based on dimple location. a dimple on the chin. My youngest has a sacral dimple but it is. February 24, 2019 ·. 5cms from anal verge o Vascular lesion e. With thousands of award-winning articles and community groups, you can track your pregnancy. 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. Sacral dimples requiring spinal Ultrasound: • Asymmetrical intergluteal crease. A duplicated gluteal cleft associated with occult spinal dysraphism. 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. 1. 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. 10 Albright,12 a neurosurgeon from Wisconsin, estimated a notably high A B. Simple sacral dimples require no further investigation whereas complex ones do. 5 cm from the anus, midline in location, and without visible drainage or additional associated. 91 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. pressure on the ankles, heels and buttocks as too much pressure can tear the thin. A coccygeal pit is a very low lying dimple with the pit pointing towards the coccygeal tip. 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. 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%.