About Sacral Dimple

Overview

A sacral dimple is a small indentation or pit located in the lower back, specifically at the base of the spinal cord near the tailbone (sacrum). It is a congenital condition, meaning that individuals are born with it. Sacral dimples are relatively common in healthy newborn babies, with a prevalence of around 2-4% of births. They are usually harmless and do not require any treatment. In most cases, sacral dimples are considered minor abnormalities that do not cause any problems as the baby grows. However, in rare instances, they can indicate a deeper spinal abnormality. It is important to note that sacral dimples may also be present in later life without causing any issues. If there are additional features such as swelling, skin tags, birthmarks, patches of hair, tenderness, or if the dimple is larger or deeper than 5 millimeters, further evaluation with an ultrasound or MRI may be necessary to rule out underlying spinal cord defects.

Causes and Risk Factors

The exact pathophysiologic causes of sacral dimple are not known, as it is a congenital condition that forms during fetal development for unknown reasons. There are no specific risk factors identified for developing a sacral dimple.

It's important to note that if there is concern about a sacral dimple being a sign of an underlying problem, further evaluation and diagnosis may be necessary. An ultrasound assessing the spinal canal is often the first test conducted in such cases. Always consult with a healthcare professional for proper evaluation and guidance.

Symptoms

The most common early symptom of a sacral dimple is a shallow depression near the end of the tailbone and the top of the buttocks. It usually doesn’t cause symptoms.

In rare instances, it may become infected or be a sign of a spinal problem. Symptoms to bring to the attention of a healthcare provider include:

Drainage of pus: In some cases, a sacral dimple can become infected, leading to the drainage of pus from the area.
Redness: An infected sacral dimple may also exhibit redness around the depression.
Swelling: Swelling can occur if the sacral dimple becomes infected or if there is an underlying birth defect involving the spinal cord or spinal bones.
Tenderness: An infected or inflamed sacral dimple may be tender to the touch.
Skin tags: In some instances, skin tags may be present around the sacral dimple.
Fatty lump: A fatty lump can develop in or around the sacral dimple in more severe cases.
Discoloration: The area around the sacral dimple may appear discolored.
Larger or deeper dimple: A sacral dimple that is larger or deeper than 5 millimeters may indicate an underlying problem.

Most cases are harmless and do not require treatment. If you notice any concerning symptoms, it's best to consult with a healthcare professional for further evaluation and guidance.

Diagnosis

To diagnose sacral dimple and determine it is associated with a serious condition, the following examinations, tests, and procedures are commonly performed:

Physical exam: A visual examination of the sacral dimple during a newborn's physical exam. The examination will look at the size of the dimple and other characteristics, such as discoloration or a nearby tuft of hair or skin tag.
Imaging studies: Depending on the symptoms and suspected complications, your healthcare provider may suggest imaging studies such as ultrasound or MRI to get a closer look at the area under the skin.

If a person with a sacral dimple experiences symptoms like muscle weakness, numbness in the legs, or loss of bladder or bowel control, it's important to see a neurologist for evaluation of a possible spinal condition.

It is important to follow up with your healthcare provider if any symptoms worsen or change after the initial physical exam. They can provide further guidance on the appropriate examinations, tests, and procedures based on your individual situation.

Treatment Options

Most cases of sacral dimple do not require treatment. If treatment is needed, treatment goals include:

Prevent infections: If the sacral dimple is larger, one goal of treatment is to prevent infection and irritation. Keeping the area clean and dry can help reduce the risk of infection or irritation. Using a diaper rash cream over the dimple in babies can help keep stool out of the pitted area.
Treat infections: If an infection occurs, it will be treated with antibiotics. In some cases, a minor operation may be needed to drain pus from an abscess.
Remove sacral dimple: In rare cases where infections persist or there are other complications, surgical removal of the sacral dimple may be necessary. This can be done through different methods depending on the symptoms.

Check with your health care professional for concerning symptoms or th need to treat sacral dimple.