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Hi Halley,

The concern with a pilonidal dimple (that's the technical term) is that if there

*isn't* a bottom to the dimple, the child's spinal cord could have problems, ie

spina bifida. You have said that your child does not have an open dimple.

Therefore I don't see anything to worry about.

Things to check on- is your daughter able to move her legs? That would be the

most obvious thing with a lower spinal cord problem. But then again, like I

said above, I don't think you have anything to worry about. I don't know why

your dr wants to do an MRI unless it has to do with the clubfoot- Jake's dr did

do an xray when Jake was a baby, to doublecheck and make sure his hips were ok.

Congenital hip deformities are fairly common with clubfoot....most drs will

check for a hip click at birth but an ultrasound or xray will give a definitive

answer.

Good luck to you and your family!

Kassia :)

3/22/01 (Lt clubfoot, ATTT #2 Oct 2005)

and 11/22/02

PS- I'm a labor & delivery nurse and we check for dimples on all of our

newborns. :)

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Hi Halley,

There was a discussion about this a while ago and it

seems that a lot of babies have that dimple (including

my two) and I don't know of anyone where a problem was

found with it so I wouldn't worry... :)

None of our doctors (peds in NICU, GP, clubfoot docs)

even mentioned it (and they can't have missed it) and

they certainly didn't do any tests regarding it so I

guess it must be quite common (I never asked them

about it either).

Hope this helps at all,

with (3y)

and Alister (3y, RCF, Ponseti method, UK)

--- Halley Prestage wrote:

> Hello,

>

> Our daughter, Keira, was born on Dec 4 with a right

> clubfoot. Like my mom

> and my 16-month old son, she has a sacral dimple (a

> dimple just above her

> anus). The pediatrician in the hospital as well as

> our family doctor who

> checked her basically just said to keep it clean and

> of course they check

> that it has an ending and is not open.

> Our orthopedic doctor who began treating her

> clubfoot last week said that he

> wants to do an MRI at some point (like when she is

> 2). Now I am worried

> about things like tethered spinal cords after

> looking on the internet. I am

> going to ask him why not just do an ultrasound or

> MRI now rather than wait

> and also, why nothing has ever been made of my son

> having it (who is doing

> great) and why the pediatrician didn't also suggest

> this. The dimple is

> right in her intergluteal crease and I've read that

> this is quite common and

> that when they are in the crease they usually don't

> suggest anything

> problematic. Does anyone know anything about this?

> Also, we had a very detailed ultrasound by a

> perinatologist at 20 weeks and

> they didn't see any problems with her spine or

> anything.

> I remember some posts quite a while ago about sacral

> dimples and didn't

> really focus on them too much.

>

> Do any of your babies/children have these and did

> they suggest an MRI or

> ultrasound?

>

> Sorry, I know I am a worrier. My husband thinks he

> ought to take the

> internet away! I am just praying that everything

> else, besides her little

> clubfoot, is normal.

>

>

> Thanks,

>

> Halley

>

>

> [Non-text portions of this message have been

> removed]

>

>

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--- Halley Prestage wrote:

> Hello,

>

> Our daughter, Keira, was born on Dec 4 with a right clubfoot. Like my mom

> and my 16-month old son, she has a sacral dimple (a dimple just above her

> anus). The pediatrician in the hospital as well as our family doctor who

> checked her basically just said to keep it clean and of course they check

> that it has an ending and is not open.

My daughter Rose was born with a sacral dimple and clubfoot.

> Our orthopedic doctor who began treating her clubfoot last week said that he

> wants to do an MRI at some point (like when she is 2). Now I am worried

> about things like tethered spinal cords after looking on the internet. I am

> going to ask him why not just do an ultrasound or MRI now rather than wait

> and also, why nothing has ever been made of my son having it (who is doing

> great) and why the pediatrician didn't also suggest this. The dimple is

> right in her intergluteal crease and I've read that this is quite common and

> that when they are in the crease they usually don't suggest anything

> problematic. Does anyone know anything about this?

Rose's ped ortho had her have an ultrasound at 4 months, and all looked fine.

The reason nothings been made of it for your son is because it usually

signifies nothing. Since your daughter had clubfoot, it's a possibility it

could signify something. Right before we went to Iowa, we had a second

opinion, and the doctor checked her dimple. I asked him why all the doctors

did this, and he said it was to check for spina bifida (then the clubfoot would

have been caused by something).

I think if you wanted you could request an ultrasound now. I'm wondering,

though, if the doctor suggested two because if there were any issues that would

probably be when they started or be more likely to be visible?

A sacral dimple that would cause tethering would be a form of spina bifida

called spina bifida occulta. I have a good friend whose son was diagnosed with

this at a year and a half. He had a deep dimple (no clubfoot), and he

developed walking issues at that time.

> Also, we had a very detailed ultrasound by a perinatologist at 20 weeks and

> they didn't see any problems with her spine or anything.

> I remember some posts quite a while ago about sacral dimples and didn't

> really focus on them too much.

An ultrasound wouldn't usually catch spina bifida occulta during pregnancy.

> Do any of your babies/children have these and did they suggest an MRI or

> ultrasound?

I think I mentioned above Rose had an ultrasound at 4 months. I think if I

were in your position I would have an u/s. If nothing shows up, don't worry

about it. If problems arise in the future, then I'd think an MRI was in order.

An MRI wouldn't be my first course of action, though, as they often sedate a

child for one.

> Sorry, I know I am a worrier. My husband thinks he ought to take the

> internet away! I am just praying that everything else, besides her little

> clubfoot, is normal.

(((hugs))) It's normal to worry a bit, I think. Just don't let worry consume

you. Worrying doesn't solve or change anything (my mantra nowadays)! Getting

the info is good. Yes, you can read things and find things and become quite

upset, but when you look at your child and the info you have, what does your

heart tell you? Does there seem to be something beyond clubfoot wrong? Is the

dimple quite normal in your opinion?

I hope some of this helps!

Joy

Rose (1-99) http://www.geocities.com/joybelle15/rosesclubfootpage.html

Iris (2-01)

Spencer (3-03)

Grant (9-05) http://www.caringbridge.org/visit/grantphilip

__________________________________________________

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Hi, Halley!

I just wanted to let you know that if needed to or wanted to have the MRI done

sooner, your baby does NOT have to be put under general anesthesia. My son had

a spinal MRI done at the end of August when he was 8.5 months and they gave him

chloral hydrate to drink which was this yucky liquid that just knocked him out

for the duration of the test. When he came back to me right after the MRI, he

was awake--groggy, but awake. It's best to find a radiology place that has

experience with children and who have given chloral hydrate to sedate children

before. Just know that you have options and that anesthesia is not the only way

to go.

That said, I'm sure the dimple is nothing to worry about. My son, too, has a

dimple, but the reason he had the MRI done was because I had noticed when he was

sitting up on his own that he was kinda leaning to one side. It ends up he has

structural scoliosis--VERY rare in babies. So they wanted to rule out any other

problems.

I wish you all the best! Enjoy the holidays and enjoy your precious little

girl! It's the best thing!

Halley Prestage wrote:

Hello,

I asked our doctor about the dimple again when Keira went for her second

cast on Thursday.

I asked him if they can simply do an ultrasound in a few months to check her

hips and dimple area. He said that the MRI has much more acuity than the

ultrasound to check her dimple area.

He said likes to wait to do the MRI until they are at least a year b/c they

must go under general anesthetic.

He said that most likely the dimple is nothing and he doesn't suspect

anything but he thinks that it never hurts to be thorough. He does seem very

conscientious...even with the casting process he seems very particular.

He said that up to 10-15% of the population could have Spina Bifida Occulta

(hidden spina bifida) and most will never have any issues and most would

never know unless you had a back x-ray for some reason, say if you injured

your back. He said that the dimples are usually nothing to worry about,

especially if they are midline, you can visualize the bottom, and are in the

intergluteal crease (all of which can be said about Keira's).

However, if the MRI did detect any tethering of the spinal cord, they can

correct it quite easily with surgery and when caught early, will almost

never be a problem. Tethering only causing problems when the child grows and

there is pressure on the spinal cord due to the tethering. Some people would

never know that their child had it until some secondary problems arose later

on during growth.

I feel much more relaxed about it now and I really feel that she will be

fine and I am praying that her dimple doesn't point to any underlying issues

though I know it is much better to be overcautious.

My son and my mom also have this so it's probably just a hereditary thing.

Anyway, I am trying not to get anxious about this and worry but I do feel

better knowing that the worst case scenario isn't as bad as I thought.

Also, he said that her foot is correcting very well even with the first cast

and this often isn't the case for clubfoot that is caused by something else.

He has also had extra training for the spine and he said that many doctors

wouldn't check but he is very thorough.

Anyway, thanks for all of your replies and info...I really appreciate it!

Have a very Merry Christmas to all of you!

Halley

Re: sacral dimple question

--- Halley Prestage wrote:

> Hello,

>

> Our daughter, Keira, was born on Dec 4 with a right clubfoot. Like my mom

> and my 16-month old son, she has a sacral dimple (a dimple just above her

> anus). The pediatrician in the hospital as well as our family doctor who

> checked her basically just said to keep it clean and of course they check

> that it has an ending and is not open.

My daughter Rose was born with a sacral dimple and clubfoot.

> Our orthopedic doctor who began treating her clubfoot last week said that

he

> wants to do an MRI at some point (like when she is 2). Now I am worried

> about things like tethered spinal cords after looking on the internet. I

am

> going to ask him why not just do an ultrasound or MRI now rather than wait

> and also, why nothing has ever been made of my son having it (who is doing

> great) and why the pediatrician didn't also suggest this. The dimple is

> right in her intergluteal crease and I've read that this is quite common

and

> that when they are in the crease they usually don't suggest anything

> problematic. Does anyone know anything about this?

Rose's ped ortho had her have an ultrasound at 4 months, and all looked

fine.

The reason nothings been made of it for your son is because it usually

signifies nothing. Since your daughter had clubfoot, it's a possibility it

could signify something. Right before we went to Iowa, we had a second

opinion, and the doctor checked her dimple. I asked him why all the doctors

did this, and he said it was to check for spina bifida (then the clubfoot

would

have been caused by something).

I think if you wanted you could request an ultrasound now. I'm wondering,

though, if the doctor suggested two because if there were any issues that

would

probably be when they started or be more likely to be visible?

A sacral dimple that would cause tethering would be a form of spina bifida

called spina bifida occulta. I have a good friend whose son was diagnosed

with

this at a year and a half. He had a deep dimple (no clubfoot), and he

developed walking issues at that time.

> Also, we had a very detailed ultrasound by a perinatologist at 20 weeks

and

> they didn't see any problems with her spine or anything.

> I remember some posts quite a while ago about sacral dimples and didn't

> really focus on them too much.

An ultrasound wouldn't usually catch spina bifida occulta during pregnancy.

> Do any of your babies/children have these and did they suggest an MRI or

> ultrasound?

I think I mentioned above Rose had an ultrasound at 4 months. I think if I

were in your position I would have an u/s. If nothing shows up, don't worry

about it. If problems arise in the future, then I'd think an MRI was in

order.

An MRI wouldn't be my first course of action, though, as they often sedate

a

child for one.

> Sorry, I know I am a worrier. My husband thinks he ought to take the

> internet away! I am just praying that everything else, besides her little

> clubfoot, is normal.

(((hugs))) It's normal to worry a bit, I think. Just don't let worry

consume

you. Worrying doesn't solve or change anything (my mantra nowadays)!

Getting

the info is good. Yes, you can read things and find things and become quite

upset, but when you look at your child and the info you have, what does your

heart tell you? Does there seem to be something beyond clubfoot wrong? Is

the

dimple quite normal in your opinion?

I hope some of this helps!

Joy

Rose (1-99) http://www.geocities.com/joybelle15/rosesclubfootpage.html

Iris (2-01)

Spencer (3-03)

Grant (9-05) http://www.caringbridge.org/visit/grantphilip

__________________________________________________

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  • 2 weeks later...

Hi ,

Thanks for your reply. Sorry not to reply sooner but with 3 little ones

under the age of 3, I find I rarely get to the computer these days! I have

so many e-mails to sift through. I will definitely ask the dr. about this

when the time comes. It does seem much safer for them than general

anesthesia.

Hope your little one is doing well!

Take care,

Halley

Re: sacral dimple question

--- Halley Prestage wrote:

> Hello,

>

> Our daughter, Keira, was born on Dec 4 with a right clubfoot. Like my mom

> and my 16-month old son, she has a sacral dimple (a dimple just above her

> anus). The pediatrician in the hospital as well as our family doctor who

> checked her basically just said to keep it clean and of course they check

> that it has an ending and is not open.

My daughter Rose was born with a sacral dimple and clubfoot.

> Our orthopedic doctor who began treating her clubfoot last week said that

he

> wants to do an MRI at some point (like when she is 2). Now I am worried

> about things like tethered spinal cords after looking on the internet. I

am

> going to ask him why not just do an ultrasound or MRI now rather than wait

> and also, why nothing has ever been made of my son having it (who is doing

> great) and why the pediatrician didn't also suggest this. The dimple is

> right in her intergluteal crease and I've read that this is quite common

and

> that when they are in the crease they usually don't suggest anything

> problematic. Does anyone know anything about this?

Rose's ped ortho had her have an ultrasound at 4 months, and all looked

fine.

The reason nothings been made of it for your son is because it usually

signifies nothing. Since your daughter had clubfoot, it's a possibility it

could signify something. Right before we went to Iowa, we had a second

opinion, and the doctor checked her dimple. I asked him why all the doctors

did this, and he said it was to check for spina bifida (then the clubfoot

would

have been caused by something).

I think if you wanted you could request an ultrasound now. I'm wondering,

though, if the doctor suggested two because if there were any issues that

would

probably be when they started or be more likely to be visible?

A sacral dimple that would cause tethering would be a form of spina bifida

called spina bifida occulta. I have a good friend whose son was diagnosed

with

this at a year and a half. He had a deep dimple (no clubfoot), and he

developed walking issues at that time.

> Also, we had a very detailed ultrasound by a perinatologist at 20 weeks

and

> they didn't see any problems with her spine or anything.

> I remember some posts quite a while ago about sacral dimples and didn't

> really focus on them too much.

An ultrasound wouldn't usually catch spina bifida occulta during pregnancy.

> Do any of your babies/children have these and did they suggest an MRI or

> ultrasound?

I think I mentioned above Rose had an ultrasound at 4 months. I think if I

were in your position I would have an u/s. If nothing shows up, don't worry

about it. If problems arise in the future, then I'd think an MRI was in

order.

An MRI wouldn't be my first course of action, though, as they often sedate

a

child for one.

> Sorry, I know I am a worrier. My husband thinks he ought to take the

> internet away! I am just praying that everything else, besides her little

> clubfoot, is normal.

(((hugs))) It's normal to worry a bit, I think. Just don't let worry

consume

you. Worrying doesn't solve or change anything (my mantra nowadays)!

Getting

the info is good. Yes, you can read things and find things and become quite

upset, but when you look at your child and the info you have, what does your

heart tell you? Does there seem to be something beyond clubfoot wrong? Is

the

dimple quite normal in your opinion?

I hope some of this helps!

Joy

Rose (1-99) http://www.geocities.com/joybelle15/rosesclubfootpage.html

Iris (2-01)

Spencer (3-03)

Grant (9-05) http://www.caringbridge.org/visit/grantphilip

__________________________________________________

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