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Simple Dimples
Many healthy babies have small dimples on their lower backs. A mother who had just graduated from nursing school came to my office hours chat this week at DrGreene.com. Her baby had one of these sacral dimples. Her pediatrician told her not to worry about it and ordered an ultrasound in two weeks. Of course she worried – especially after a quick online search of sacral dimples raised questions of spina bifida and neurologic problems. So, at her request, I’m making what we chatted about available for others who are concerned about sacral dimples -- the simple dimple plan for parents. The first thing that parents need to know is that sacral dimples and related findings are common: about 1 in 20 babies. And most babies with midline sacral dimples are healthy. Occasionally, these dimples can be a sign of a spinal problem underneath. Sometimes, they are not even true dimples at all, but narrow open tubes that connect to an internal structure such as the intestines or the spinal canal. How do you tell the difference between dimples to smile about, and those to look into further?
There are four simple things to consider:
Is the dimple
- deep (the bottom can’t be seen)
- large (>0.5 cm in diameter)
- high on the back (> 2.5 cm above the anus) or
- associated with other skin findings at the site of the dimple (a tuft of hair, a tail, or a Hemangioma)?
If the answer to any of these is yes, then a closer look, such as an ultrasound, may be in order to see what is underneath. Even so, in one study of babies who met at least one of these criteria, most of the dimples (60 percent) turned out to be normal findings in healthy kids. Most of the dimples that did turn out to be problematic were both high on the back and also associated with other skin findings.
Simple dimples that don’t meet any of the above criteria turned out to be normal findings in 100 percent of the babies studied. In otherwise healthy babies, no ultrasound or other workup is recommended for simple dimples.
Click here to hear the audio of this article.
Alan Greene MD FAAP
Reviewed by Alan Greene MD FAAP December 2005
July 26, 2005 | Permalink
Comments
Hi, My son, husband and mother-in-law all have the sacral dimple. My husband got a pilondial cyst a few years ago and his doctor wanted to do surgery. I bought these Chinese detox patches on ebay and made him put the patch in his crack while he slept and the cyst and pain were gone the next day! It hasn't come back in years and he never needed to see the doctor again. When my son gets older I will make sure he keeps his dimple hair free and buy some detox patches just in case.
Posted by: Becky | May 7, 2008 7:50:10 PM
I am 25, I have diagnosed myself with a Sacral Dimple, Thru many many pages of internet research I have found almost nothing about adults with the condition. Up untill a few years ago it was never an issue. I have no pain. The most you parents should worry about (unless the doc. says otherwise) is the emotional stress an adult may have from this, Since it it a physical "defect" or noticable indent in the buttocks it makes for uncomfortable sexual intamacy. I am embarresed about it. I usually "Nair" the small patch of hair that grows (its really not much at all). When I tell my boyfriend about it, I usually start out with the worst senario of Spinal Bifida. This usually make for a sympathy reaction rather than someone being "grossed out". I mean 'cause think about it, it looks like another hole. Not attrative. but I deal. I guess that is the long term effects of the condition.
Posted by: Mary | Apr 24, 2008 5:28:49 AM
MY DAUGHTER HAS TWO DIMPLES,ONE ON EACH SIDE OF HER CREASE AT THE TOP OF THE BUTTOCKS.SHE HAS HAD AN ULTRASOUND WHEN SHE WAS ABOUT 4 MONTHS OLD,BUT DOCTORS WERE NOT ABLE TO SEE ANYTHING.SHE HAS BEEN REFERRED TO HAVE A MRI,BUT I'M JUST NOT SURE ABOUT HER HAVING ONE. MY DAUGHTER IS NOW 19 MONTHS AND HER MOTOR SKILLS ARE WONDERFUL.I JUST WANT TO WHAT SHOULD I DO AND SHOULD I BE WORRIED ABOUT ANYTHING.
Posted by: JAMIE ARMSTRONG | Mar 31, 2008 1:51:01 PM
im 21 and i believe that i have a sacral dimple. up until recently when my boyfriend asked what it was. i thought it was normal and that everyone had it. i have constant lower back pain. my sd is about 1cm wide and it is deep and and two inches from my anus. my mom teased me as a kid about having a crooked crack.i wonder if she knew i had one?!
Posted by: ec:( | Jan 6, 2008 9:43:24 PM
My son is three months old now and I discovered he had a sacral dimple upon taking him home from the hospital (they missed discovering it when he was in the NICU). We had an ultrasound done which showed that most likely there was no spinal involvement, but it did show a long sinus tract that they were unsure of where it led, and so they want to do an MRI when he's 6 months old. I really don't want to have him sedated for this -- what are the implications of refusing this -- or what is the worse case scenario? My dad says he also had a large deep sacral dimple as my son has --- can it be genetic? My son has no obvious neural deficits or impaired movement. Is it irresponsible to refuse the MRI unless there appears to be a medical reason for it?
Posted by: Alicia | Jan 1, 2008 12:32:51 AM
I had a friend who's baby had one and dr. insisted on an mri. The baby ended up being fine but after taking a nap when she got home she never woke up. :( I would think twice about this procedure.
Posted by: lori | Dec 20, 2007 4:47:07 PM
My daughter has sacral dimple as well as tuft of hair, 2days old had Ultrasound, cord is not tethered, Dr. has adviced MRI after 4 months
Posted by: manisha | Dec 10, 2007 9:18:54 PM
my daughter has a sacral dimple with a tuft of hair growing out of it. the first pediatrician i went to said dont worry about it. i was worried it didnt sseem normal to me cause i never heard of it before. i went to the best pediatrician in the area. he said not to worry the hair could be because she is italian...but ordered an u/s anyway.
the u/s showed a tract going from her spine to the dimple. the radiologist said that her cord is not tethered. we were told we needed to see a neurosurgeon. well they recommended the chief neurosurgeon at the best childrens hospital around. im of course scared out of my mind. my daughter is now 4 1/2 weeks old...i dont know what to think.
so yesterday 11/2/06 we went to the neurosurgeon and he wanted an mri. here her cord is tethered (borderline tethered) and he wants to wait on surgery for 3 months to re-evaluate her.
and right now im waiting to hear from the dr today on possible scoliosis of the spine and a cyst that was found as well!
but no tract from the spine to the skin...
how can these dr's vary in what they see?!
im scared to pieces and have done nothing but crying constantly.
i dont want her to have any neurological problems and im scared...
Posted by: Angeline | Nov 3, 2006 6:56:26 AM
My 4 month old daughter has got 2 sacral dimples or pits in the crease of her buttocks.
I was asked by the plunket nurse to get it checked by the GP, When i showed him, he began looking for more info on the net as well as ringing other doctors, I was advised not to worry, but how can you not. Is is something i should be worried about, will she have a minor case of spinal bifida what do i do?????
Posted by: Daniella | Sep 20, 2006 2:10:21 AM
I was born with what l assume is Sacral Dimple, by research l have done. I have been getting a sore tail bone from sitting. I have discovered this since lossing weight. I also get sharp pains in the area. I also have been relising my posture not to be good hence positioning myself so my tail bone doesnt hurt. What can l do about this?
Posted by: Matthew & Kylie Allan | Jul 27, 2006 3:34:01 PM
My son had Sacral dimple at birth. It is within the crease, just above the anus. Pediatricians at the hospital got the ultrasound done and said that it is NOT connected to the spine and there is nothing to worry about except that when he grows into an adult he may have to keep it clean to take care of infections etc..
When I went to the Pediatrician later she said that although it should not be a worry but since she could not see the bottom of the dimple, we may want to get MRI done if we are too worried. I declined as I do not want my son to be sedated.
She said one of other kids who comes to her too had it and by the age of 9 months, it disappeared by itself.
I chose to wait since my son have everying normal. Is it OK to wait for a few months before going for MRI or should I just not worry as Ultrasound was OK.?
Posted by: AarBee | Jul 6, 2006 12:50:03 AM
My son had Sacral dimple at birth. It is within the crease, just above the anus. Pediatricians at the hospital got the ultrasound done and said that it is NOT connected to the spine and there is nothing to worry about except that when he grows into an adult he may have to keep it clean to take care of infections etc..
When I went to the Pediatrician later she said that although it should not be a worry but since she could not see the bottom of the dimple, we may want to get MRI done if we are too worried. I declined as I do not want my son to be sedated.
She said one of other kids who comes to her too had it and by the age of 9 months, it disappeared by itself.
I chose to wait since my son have everying normal. Is it OK to wait for a few months before going for MRI or should I just not worry as Ultrasound was OK.?
Posted by: AarBee | Jul 6, 2006 12:46:14 AM
my 16 month old daughter had an ultrasound in January for a sacral dimple which is within the crease but is deep. Apparently this did not show a tethered spine but she has still been sent for an MRI (29.06.06. Are there other underlying problems we should be worried about?
Posted by: KERRY | Jun 27, 2006 6:58:28 AM
My son has a sacral dimple. I didn't even know what it was called until last night when I was reading about it on a pregnancy message board. My doctor saw the sd at his 6 month check up and didn't say anything at all about it. I thought it was normal. My son's is small and right over his buttocks. I'm glad to see that it is nothing to worry over:)
Thanks Dr. Greene
Jessica
Posted by: Jessica David | Mar 5, 2006 11:28:01 AM
My grand son of 5 weeks has a sacral dimple. An ultrasound reveal that the dimple is connected to the spinal cord. I didn't say any thing yet to the mother about the ultrasound findind.What is the consequence of the connection with the spinal cord? Please answer me.
Posted by: Mariefrantz A Lemoine | Nov 23, 2005 5:22:29 AM
My grand son of 5 weeks has a sacral dimple. An ultrasound reveal that the dimple is connected to the spinal cord. I didn't say any thing yet to the mother about the ultrasound findind.What is the consequence of the connection with the spinal cord? Please answer me.
Posted by: Mariefrantz A Lemoine | Nov 23, 2005 5:20:37 AM
