Question:
An infant is noted to have midline cutaneous lesions suggestive of spinal dysraphism. In which of the following lesions is imaging not indicated?
An infant is noted to have midline cutaneous lesions suggestive of spinal dysraphism. In which of the following lesions is imaging not indicated?
Show Hint
Indications for Spinal USG/MRI in Sacral Dimples:
$\bullet$ High Risk (Image!): $>2.5\text{ cm}$ above anus, $>5\text{ mm}$ size, base not visible, hairy tuft, lipoma, or hemangioma.
$\bullet$ Low Risk (Do NOT image): Single simple dimple $<5\text{ mm}$ within gluteal cleft $\le 2.5\text{ cm}$ from anus with visible base.
$\bullet$ High Risk (Image!): $>2.5\text{ cm}$ above anus, $>5\text{ mm}$ size, base not visible, hairy tuft, lipoma, or hemangioma.
$\bullet$ Low Risk (Do NOT image): Single simple dimple $<5\text{ mm}$ within gluteal cleft $\le 2.5\text{ cm}$ from anus with visible base.
Updated On: Sep 3, 2026
- Lipoma
- Tuft of hair
- Coccygeal pit
- Aplasia cutis
Show Solution
Verified By Collegedunia
The Correct Option is C
Solution and Explanation
Concept:
Occult spinal dysraphism (OSD) refers to closed neural tube defects where the underlying spinal cord or filum terminale malformation is covered by intact skin.
Cutaneous markers along the midline back serve as crucial surface indicators of underlying dysraphism or tethered cord syndrome, requiring radiological screening (spinal ultrasound in infants $<6$ months or MRI in older infants).
Explanation:
• High-risk cutaneous stigmata that strictly require neuroimaging (spinal ultrasound or MRI) include:
1. Subcutaneous lipoma or fibrofatty mass
2. Hypertrichosis localized hairy patch (faun tail)
3. Atypical dimples (located $>2.5\text{ cm}$ above the anal verge, diameter $>5\text{ mm}$, or multiple dimples)
4. Aplasia cutis congenita or dermal sinus tract
5. Hemangiomas ($>2.5\text{ cm}$), caudal appendages pseudotails
• A simple coccygeal pit simple sacral dimple is an extremely common, benign variant found in up to $4$--$5\%$ of normal healthy newborns.
• A simple dimple is defined as a small ($<5\text{ mm}$ in diameter) pit situated within the gluteal cleft within $2.5\text{ cm}$ of the anal verge, where the base of the pit can be clearly visualized without associated cutaneous markers.
• These low-risk simple coccygeal pits do not communicate with the subarachnoid space and do not represent occult spinal dysraphism; hence, diagnostic neuroimaging is not indicated.
Final Answer:
A simple, solitary coccygeal pit located within the gluteal cleft is a benign finding for which spinal neuroimaging is not indicated.
Occult spinal dysraphism (OSD) refers to closed neural tube defects where the underlying spinal cord or filum terminale malformation is covered by intact skin.
Cutaneous markers along the midline back serve as crucial surface indicators of underlying dysraphism or tethered cord syndrome, requiring radiological screening (spinal ultrasound in infants $<6$ months or MRI in older infants).
Explanation:
• High-risk cutaneous stigmata that strictly require neuroimaging (spinal ultrasound or MRI) include:
1. Subcutaneous lipoma or fibrofatty mass
2. Hypertrichosis localized hairy patch (faun tail)
3. Atypical dimples (located $>2.5\text{ cm}$ above the anal verge, diameter $>5\text{ mm}$, or multiple dimples)
4. Aplasia cutis congenita or dermal sinus tract
5. Hemangiomas ($>2.5\text{ cm}$), caudal appendages pseudotails
• A simple coccygeal pit simple sacral dimple is an extremely common, benign variant found in up to $4$--$5\%$ of normal healthy newborns.
• A simple dimple is defined as a small ($<5\text{ mm}$ in diameter) pit situated within the gluteal cleft within $2.5\text{ cm}$ of the anal verge, where the base of the pit can be clearly visualized without associated cutaneous markers.
• These low-risk simple coccygeal pits do not communicate with the subarachnoid space and do not represent occult spinal dysraphism; hence, diagnostic neuroimaging is not indicated.
Final Answer:
A simple, solitary coccygeal pit located within the gluteal cleft is a benign finding for which spinal neuroimaging is not indicated.
Was this answer helpful?
0
0
Top NEET SS Paediatrics Questions
- A 2-year-old child presents with persistent fever for 4 days. Examination shows conjunctival injection and periungual desquamation, but criteria for complete Kawasaki disease are not met. You plan to evaluate for incomplete Kawasaki disease as per AHA guidelines. Which of the following investigations is NOT routinely recommended in this evaluation?
- A 27-year-old pregnant woman with systemic lupus erythematosus (SLE) is concerned about the risk of congenital heart block in her fetus due to anti-Ro/SSA antibodies. Which of the following medications is not recommended antenatally to prevent cardiac manifestations of neonatal lupus?
- A 2-week-old infant presents with a photosensitive annular erythematous rash on the face. ECG reveals complete heart block. Which is the most likely diagnosis?
- A 10-year-old child presents with arthritis involving the wrist and first MCP joint. Examination shows nail pitting. Which of the following is the most likely diagnosis?
- A 14-year-old girl with SLE presents with edema and nephrotic-range proteinuria. Renal biopsy shows diffuse thickening of the glomerular basement membrane without proliferative lesions. This corresponds to which class of lupus nephritis?
View More Questions
Top NEET SS Neurodevelopment Questions
- A 3-month-old infant, born at 30 weeks gestation, is brought for developmental follow-up. On assessment, the infant shows absence of fidgety movements and cramped-synchronized general movements. According to the Prechtl General Movements Assessment, what does this finding most strongly predict?
- A 4-year-old child has normal comprehension and cognitive abilities but difficulty planning and coordinating speech movements. Speech is effortful, inconsistent, and the child often struggles to produce the correct sounds. What is the most likely diagnosis?
- For the diagnosis of attention deficit hyperactivity disorder (ADHD), symptoms should start before which age?
- A child cannot sit still, is constantly moving, and shows very restrictive and stereotypical play. What is the most likely diagnosis?
Top NEET SS Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions