Sacral Dimple – Diagnosis and Treatment

Diagnosis

Doctors usually notice a sacral dimple during a baby’s first physical exam. They check its size, depth, and whether there are other signs nearby like a patch of hair, a skin tag, or swelling.

If the dimple looks unusual or is large, doctors may recommend more tests.

Common diagnostic steps:

• Physical Exam: Doctors look for skin changes, swelling, bruising, or unusual lumps near the sacrum.
• Ultrasound: Doctors use ultrasound to see the spinal canal and lower spinal cord, especially in infants.
• MRI: MRI provides detailed images to spot structural issues like tethered spinal cord, spinal dysraphism, meningocele, myelomeningocele, or types of spina bifida.

Sometimes, doctors order an x-ray to rule out bone problems. These tests help identify any neural tube defects or conditions affecting the spinal cord.

Treatment

Simple sacral dimples—those that are small, shallow, and located near the top of the buttocks without signs of infection or a deeper connection—do not usually require treatment or surgery.

These are often harmless and found during newborn checkups. Treatment may be considered if the sacral dimple is:

• Deep, wide, or unusually located.
• Associated with a tuft of hair, swelling, skin tag, or discoloration.
• Linked to other symptoms like fluid drainage, redness, or swelling.

In such cases, doctors may:

• Order imaging tests, such as ultrasound or MRI, to check for a connection to the spinal cord or conditions like spina bifida occulta or tethered cord.
• Refer to a specialist in neurology or pediatric surgery if a deeper issue is suspected.

If an underlying spinal issue is confirmed, treatment may involve:

• Monitoring with regular checkups and imaging.
• Surgical correction in rare cases, such as to release a tethered spinal cord or remove a dermal sinus tract.

If the area becomes infected or drains fluid, doctors may prescribe:

• Topical or oral antibiotics for infection.
• Minor procedures to drain fluid if necessary.

Getting Ready for Your Visit

Before you take your child to the pediatrician about a sacral dimple, keep track of any changes in the area. Write down any concerns or questions you have. Helpful questions to ask at the appointment include:

• Does my child need any medical tests?
• Is special cleaning or home care needed?
• Is treatment required?
• Can a dimple be linked to serious health conditions?