Sacral dimple?

cheekyali

Anyone's LO have this and had to have it checked out with an ultrasound? DS has had this since birth and his pedi said it looked fused so we didn't need to do anything. Now,my pedi is on maternity leave and her sub is telling us we should have an ultrasound just to be sure. If anyone has any experience on this subject please let me know what happened. TIA

sliz

DD has a deep one and we did an u/s - she looked fine - the dr thought it was unlikely for anything to be wrong because she has good leg strength and moves well but he wanted to be sure

lolalillie

My DS has one and he had an ultrasound in the hospital.  Every pedi we have seen since he was born (we have seen three) have always been concerned about it and wanted to know if he had an ultrasound to check it out.  I think that pedis tend to be very careful with sacral dimples because of their implications.  In our case, our DS was fine.  My guess is that the fill-in pedi is just being cautious.  I know it seems so scary   Please keep us posted   Take care!!!

emmyloustu

My daughter is 13mo and has had a sacral dimple since birth. We are currently in the thick of testing to determine if she has tethered cord - which is the most common reason for a sacral dimple.

I will share my experience and my thoughts and I hope it helps and saves you a headache. I don't want to stress you out, but I am going to be brutally honest about our experience b/c it has been really stressful! First, you should know that your pedi cannot tell anything simply by looking at it so she has done you a major disservice by saying because it is fused it is fine. Bottom line - a sacral dimple should ALWAYS be examined via ultrasound at birth to see if the spinal column closed correctly.

Second, I totally agree with your sub-pedi that it needs to be looked at more closely; however, your LO is now too old to have a conclusive ultrasound of the spine done and I know this from our experience. The window for conclusive spinal u/s is 6 months old, MAX.

So, our story is this:

Eliza was born with a sacral dimple and a u/s was performed when she was 1 day old in the hospital. At the time, we were told that her spinal column/cord was normal and that the dimple was just a birthmark. Fine, ok. New mom told by radiologist that u/s was normal - I never even gave it a 2nd thought. In fact, I'm not sure I even understood what they were looking for. 

When she was a few weeks old, she developed a hemangioma at the site of the dimple that spread to her anus. Pedi says - no biggie just a birthmark.

Fast forward a few months - move out of state - new pedi. I point out dimple and hemangioma and new pedi asks if u/s was ever done. I say yes and it was normal. End of story until her 9mo appt. 

I see another pedi in the rotation at her 9mo appt and mention that sometimes the hemangioma sometime bleeds. She takes a more careful look and says because it is in such a strange spot and seems to go hand in hand with the dimple that she wants us to see a dermatologist. 

We see a pediatric derm at local children's hospital and she takes some pics and immediately asks if this was ever examined by u/s. Yes and normal, but since I don't have the report anymore, she refers us for repeat u/s at the children's hospital to get a second look. 

We go to u/s and Eliza is now just short of 10mo old. The radiologist comes right in and explains that a u/s NEVER should have been ordered because she is too old. Apparently after 6mo, the bones become more dense and it is too hard to get a clear image. He says he will personally do it himself instead of just the tech, but warns us that it will likely be inconclusive. 

Eliza freaks out the entire time which makes it even more difficult to get a good series of images. Radiologist concludes that it is in fact, inconclusive, but that he honestly has concerns because spinal cord does not seem to be at the correct location. He cannot be sure though so he calls the hospital where she was born and requests the films and report from her newborn u/s. 

He reads them right there with us and says his DISAGREES with the report from her newborn u/s and is even more concerned about tethered cord. He explains that u/s is a very user dependent science and open to interpretation and is very hard to interpret after the fact. He advises us to meet with a neurosurgeon to be sure. 

It takes another few months to get into the pediatric neurosurgeon and he does a full body exam and rereads both u/s reports. He concludes that with two inconclusive u/s results, the dimple, the birthmark and this weird toe thing she has going on, that the only way to know for sure the condition of her spine is to do an MRI. The MRI needs to be done under general anesthesia at this age because they need the baby to be perfectly still. He explains that best case scenario the MRI will be conclusive one way or the other - either normal spine or tethered cord, BUT, there is still a chance that MRi could be inconclusive at which point, he would assemble a team of urologists and orthopaedics to conduct nerve testing. Because tethered cord left untreated can do irreversible nerve damage, if it is tethered, it would have to be repaired surgically. He explained, the pedis have so much misinformation on sacral dimples/tethered cord because there are so many variables and symptoms and can vary from severe (child cannot walk or bear weight) or child can appear 100% normal. In fact, one of the pedis on our staff told us because she has good muscle tone and bears weight and stands and cruises that there was "no way" she had tethered cord. The neuro said that is a common myth, but completely untrue!!!

Her MRI is scheduled for next Monday the 14th and we are praying for a conclusive result one way or the other.

I know that is a TON of info and I don't want to overwhelm or scare you, but there are things I wish I knew going into it that would have saved us a lot of time and stress. For example, we never would have done the 2nd u/s at 9mo - we would have asked for a referral to neuro right away and let him make the calls. 

So, if you have any ?s, don't hesitate to contact me - page me or PM and I can send you my email, if you want! 

GOOD LUCK!!!! 

cmw&tdm

DD has one that the doctors never noticed until I did when she was 9 mos or so.  I had our ped check it out and he said that since it's so shallow and low that it is not an issue.  I had our new ped also check it out and she said that they are very common, her youngest has one, and that we had nothing to worry about with DD's.  

 

LisaMarisa

I have one, my DS has one and I found out from my aunt that my cousin has one.  So maybe it could be genetic in some cases?  No one ever did an u/s on DS.