A patient presents with a midline patch of hair over the lower back. Which of the following statements regarding the diagnosis is false?
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Cutaneous markers for Occult Spinal Dysraphism (Type I) include: Faun tail, sacral dimples, midline lipomas, and capillary hemangiomas.
Any infant with these signs requires a spinal ultrasound or MRI to rule out a tethered spinal cord before any intervention.
Concept:
The clinical image and description highlight a localized tuft of coarse hair situated over the midline of the lumbosacral region in an infant.
This cutaneous stigma is a classic indicator of an underlying neural tube defect. The task is to identify the false statement regarding the classification of this specific defect. Explanation: • A midline patch of hair on the lower back is clinically termed a "faun tail".
• This specific finding is one of the most reliable cutaneous markers for an underlying spina bifida occulta.
• Spinal dysraphisms are broadly classified into two main categories based on whether the neural elements are exposed or covered by skin.
• Type-I spinal dysraphism refers exclusively to closed (occult) defects, where the neural elements and spinal anomalies are completely covered by intact, although sometimes altered, skin (like the hair patch).
• Therefore, because the skin in the image is intact, this patient definitively has an occult spinal dysraphism (Type-I).
• Statements A, C, and D accurately describe this exact condition.
• Type-II spinal dysraphism refers to open neural tube defects (spina bifida cystica), such as a myelomeningocele or meningocele, where the meninges or neural placode are frankly exposed to the environment without intact skin coverage.
• Since the patient has closed, intact skin, claiming this is a Type-II dysraphism is anatomically and clinically false. Final Answer:
The statement claiming this is a type-II spinal dysraphism is false, as the intact skin indicates a closed (occult, Type-I) defect.
