when should  we be concerned?

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• Existence of other cutaneous stigmata for dysraphism, such as: hair tufts, hemangioma, skin discoloration/depigmentation, skin folds, deviated gluteal clefts, soft tissue masses

• By physical examination of the dimple- Base of dimple is not visible or not covered with skin

•  Any other associated neurological signs or symptoms such as: motor weakness, incontinence, chronic pain, parasthesia

• If the dimple located more than 2.5 cm above the anus.

• Position is outside the gluteal fold

• If the size of the dimple is more than 0.5 cm.

• Dimple is oriented cephalically (i.e. toward the head)

• More than 1 dimple is seen

• Family history of spinal disraphism

•  Check next page for suggested scheme for sacral pit or dimple

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​​Sacral dimple/pit found in 3-5% of normal babies.